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Alcohol and Public Policy: Beyond the Shadow of Prohibition (1981)

Chapter:The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences

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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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Suggested Citation:"The Role of Nonalcohol Agencies in Federal Regulation of Drinking Behavior and Consequences." National Research Council. 1981. Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: The National Academies Press. doi: 10.17226/114.
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The Role of Nonalcoho! Agencies in Federal Regulation of Drinking Behavior and Consequences JAMES F. MOSHER and JOSEPH R. MOTTE INTRODUCTION This paper outlines and discusses an important finding—that significant aspects of the federal response to alcohol problems are formulated by federal agencies not usually associated with alcohol policy. We provide a survey of federal agencies with various types of jurisdiction over al- cohol distribution and alcohol-related problems and examine their po- tential role in the federal effort to address these issues effectively. In addition to identifying potential new actors, the paper also suggests potential new prevention strategies. We hope that we have provided a constructive, preliminary analysis of possible policy initiatives. Research for this report was completed March 1980, and any changes in regulations or policies since that time are not included. Preparation entailed contacting numerous federal employees who, in virtually every instance, were both extremely courteous and helpful, often in the face of many competing demands. Their assistance was invaluable. FEDERAL AUTHORITY TO REGULATE THE ALCOHOL MARKET Since the end of Prohibition, federal responsibility for regulating the distribution of alcoholic beverages and the prevention of alcohol-related James F. Mosher and Joseph R. Mottl are at the Social Research Group, School of Public Health' University of California, Berkeley. Preparation of this report was partly supported by a National Research Center grant to the Social Research Group, AA-03524. 388

The Role of Nonalcohol Agencies 389 problems has been generally viewed as limited a secondary, advisory responsibility that gives deference to the various states' primary role. The Bureau of Alcohol, Tobacco, and Firearms (BATF) and the Na- tional Institute of Alcohol Abuse and Alcoholism (NIAAA) are the primary federal agencies affecting the national alcohol policy. Both of these agencies defer to state authority in important ways. Although many BATF regulations are mandatory, they may not contradict any of the more restrictive state policies. In fact, many BATF provisions take effect only if particular states have similar or identical provisions. NIAAA has emphasized treatment and rehabilitation programs that, although based on a perceived need for national action, are usually voluntary and require state or private cooperation. The basis for this limited view of federal jurisdiction rests in large part on the 21st Amendment, which ended Prohibition in 1933. That amendment gave alcohol a unique position in interstate commerce by limiting federal preemptory and interstate commerce powers.) It pro- vides that alcohol may not be imported into any state contrary to the laws of that state. Thus? unlike any other legal commodity, the federal government in most instances cannot regulate alcohol in a state unless federal regulations are at least as strict as the state's provisions. However, despite this grant of special power to the states to restrict the importation of alcohol and its production and distribution within its boundaries—federal power remains substantial in four ways. First, the federal government may enforce stricter regulations than those found in the states. For example, BATF regulations prohibiting moonshining would stand and federal agents would still have authority to enforce them, even if particular states chose to legalize moonshine. In effect, states and the federal government have concurrent jurisdiction over the alcohol market, with federal regulations at least as strict as comparable state provisions. Second, the states, as a practical matter, have chosen for the most part not to regulate the alcohol industry other than at the retail level, a decision that the federal government has encouraged (Mosher 1978c). ~ The 21st Amendment makes alcohol a unique commodity vis-a-vis federal powers over interstate commerce. See State Board of Equalization of California v. Young's Market, 299 U.S. 59 (1936~. However, the U.S. Supreme Court, in more recent cases, has made clear that the state powers under the 21st Amendment are not absolute. See, e.g., Hostetter v. Idlewild Bon Voyage Liquor Corporation, 377 U.S. 324 (1964) (in which the Court held that the state could not regulate sales by a retailer who sold exclusively to persons as they entered an airplane to leave the state and travel overseas). For a review of Supreme Court action regarding the 21st Amendment, see the majority opinion in California v. LaRue, 409 U.S. 109 (1972~. For a discussion of state and federal powers over the alcohol market, see Mosher (1979b).

390 MOSHER and MOTTL Only those states with a significant local alcohol industry have taken an active role with respect to regulating production, usually in a manner that fosters development of the industry (Bunce 1979~. Third, a significant portion of the alcohol regulations and alcohol- related problems are tangential to the constitutional provision. For ex- ample, the 21st Amendment does not prohibit federal taxation or na- tional import-export jurisdiction, yet these powers may have a powerful influence on the structure of the alcohol market. Safety regulations relating to auto travel or house construction may affect the extent of alcohol-related problems, despite their being unrelated to state alcohol jurisdiction. Finally, there are significant exceptions to the 21st Amendment. Fed- eral reserves and lands, including Indian reservations, are not necessarily considered to be within a state's boundary for the purpose of the con- stitutional amendment.2 A state may not block access to and may not tax alcohol or regulate alcohol use or distribution on federal property unless agreed to by the federal government. SCOPE OF THE PAPER Much of this federal authority, which rests largely outside BATE and NIAAA, has been ignored in the formation of federal alcohol policy and in most alcohol literature. Two areas in particular appear to have been neglected the regulation of alcohol availability and the regulation of drinking contexts. As to availability, there has been a recent emphasis in the literature on studying alcohol beverage control laws and pricing policies as a means to deter alcohol problems (Bruun et al. 1975, Doug- lass and Freedman 1977, Medicine in the Public Interest 1976, Mosher 1979a, Room and Mosher, 1979~. This strategy has been viewed as problematic because of the reluctance of state legislatures, alcohol bev- erage control (ABC), and the BATE to accept a preventive role (Med- icine in the Public Interest 1976, Mosher 1978~. Federal agencies and departments that have broad taxing and availability powers (many of which are acting at cross purposes to NIAAA priorities) have been ignored. Regulation of drinking contexts has been more generally ignored. The advent of prevention of alcohol problems as a specialized field of study has created a broad range of literature linking alcohol to a host of social 2 See Collins v. Yosemite Park and Curry Co., 304 U.S. 518 (1938); Yellow Cab Transit Co. v. Johnson, 48 F. Supp. 594. affirmed. 137 F. 2d 274. affirmed 321 U.S. 383 (1942). For discussion of federal authority on native American reservations. see Mosher (1975).

The Role of Nonalcohol Agencies 391 problems- accidents, crimes, and diseases (Aarens et al. 1977~. Alcohol has been demonstrated to be a causal factor in these problems, and prevention strategies have emphasized deterring the drinking behavior rather than addressing other causal factors surrounding the drinking context. For example, strategies to deter drunk driving stress the ab- stinence from drinking before and during driving rather than other causal factors of accidents e.g., unsafe cars and highways. As Gusfield (1976) points out, such an emphasis unnecessarily narrows the range of poten- tial prevention strategies. Gusfield's observation is relevant to other areas of alcohol casualties. Numerous federal agencies that do not deal with alcohol per se exercise broad jurisdiction over casualties associated with alcohol abuse. Natural alliances among these agencies and alcohol prevention strategists are not being exploited. This study explores these two areas in detail. For convenience, the agencies studied are divided into four categories of jurisdiction: land- based, transportation-based, safety-based' and economic-based agen- cies. Land-based agencies determine the availability of alcohol within their boundaries; safety agencies may reduce the risk of casualty in contexts in which alcohol may be a factor; and economic-based agencies have power to regulate the economic structure of the alcohol market. Transportation agencies have characteristics of both land-based and safety-based agencies; however, they are distinctive because of the unique nature of their powers. The general characteristics of each category are first outlined and then followed by a description of the major agencies involved. The agencies' jurisdiction and powers are discussed in general, as is their authority over alcohol distribution and alcohol-related problems. Current alcohol- related procedures and regulations are also outlined.3 For each category (except that of economic-based agencies, which is only briefly described) at least one agency has been chosen for an in- depth analysis of its potential role in federal alcohol policy. An assess- ment of the likelihood of the agencies' responding favorably and chang- ing their current policies is presented. Assuming that reform is judged possible, specific reforms are suggested' followed by the effects that can be expected. Judging the advisability of any particular change in policy requires an assessment of the possible benefits and costs (which includes, in addition to financial expenditures' possible detriments to other positive goals). Resistance to change may be caused because of potential conflict with 3A list of the regulations covered in the discussion in each section is provided in the appendix. Exact citations are available on request to the authors.

392 MOSHER and MOTTE other important societal values. However, agencies often resist public- health-oriented change, even when there are no costs or conflicting values, merely because it appears to fall outside their immediate mission. In such cases, reform may be both reasonable and important. For the prevention strategist, the more persuasive the evidence that a particular reform will reduce alcohol problems? the more likely that possible costs of the reform can be outweighed. However, other types of reforms may provide benefits, short of proven problem reduction, that may be pursued because of the minimal costs involved. Symbolic reform includes policy initiatives that provide a uniform federal ap- proach to alcohol, even though the reform will have little actual impact. These can have an important though unmeasurable significance in terms of heightening awareness of particular problems and legitimating other policy initiatives. Experimental programs to determine the advisability of a particular reform may be justified even if results are uncertain and provided costs can be accurately judged and are acceptable. Statistical analyses and compilations of the role of alcohol in various casualties, which usually involve only minimal costs, are also important as a means to further understanding the scope and role of alcohol in societal problems. As a recent, extensive study has documented (Aarens et al. 1977), there is a vital need to compile accurate data in this area. Most agencies that are attempting to cope with alcohol-related societal problems currently do not consider alcohol as part of their jurisdiction or concern. Encouraging statistical compilations, then, could provide valuable information and contacts. Finally, in some cases, advocating policy changes or addressing particular issues in agencies not specifically involved with alcohol may be necessary, even when the evidence indi- cates that no policy change in the near future is likely. They may highlight previously ignored issues and problems and create debate and further study. As this discussion indicates, determining what reforms are appropriate depends on a given agency's view of its own mission as well as its receptiveness to new directions. Key factors are the agency's statutory mandate and responsibility. For example, if an agency is mandated to collect statistics to determine the causal factors of particular accidents, there may be a strong basis for urging the agency to include alcohol as a potential variable. We have outlined the scope of statutory respon- sibility (and have also talked with staff to determine each agency's own view of this responsibility) in an attempt to determine the importance of a given set of alcohol-related problems to agency goals and respon- sibilities. This provides a sound basis for determining what potential strategies would be most appropriate.

The Role of Nonalcohol Agencies 393 As with any proposal for governmental change, the actual imple- mentation of a given reform may involve complex negotiations and unforeseen obstacles. Practical guides may prove to be useful, in par- ticular suggesting whom to approach inside and outside the agency to promote new directions in alcohol policy. We outline the realistic bound- aries of potential new prevention strategies among these agencies. Pro- viding tactical guides for implementation falls beyond the scope of this paper. It must be stressed that the areas covered in this paper are at an experimental stage generally. The relationship of the structure of the alcohol market and alcohol-related problems is a recent subject of in- quiry. Very few studies have been conducted, primarily because of a lack of interest on the part of the industry and the state regulators. Even less is known about the role of safety agencies in reducing alcohol- related problems. Our effort here is to describe the various agencies' potential role, providing both potential new strategies and potential new allies in the government's effort to reduce alcohol's role in societal problems. FEDERAL LAND-BASED JURISDICTION OF ALCOHOL DISTRIBUTION INTRODUCTION Although state regulations dominate the retail market of alcoholic bev- erages, there is a vast expanse of land controlled by the federal gov- ernment. Alcoholic beverage control within the boundaries of federal lands is placed with the federal agency in charge, and those agencies may choose to exercise their authority either exclusively or concurrently with the states (unless the federal legislation provides otherwise). Court decisions have explicitly held that the 21st Amendment does not nec- essarily give states jurisdiction over the distribution of alcoholic bev- erages on federal land.4 The major federal agencies with authority to regulate alcohol distri- bution are: the Department of Defense; the National Forest Service; the Bureau of Land Management; the National Park Service; the Army Corps of Engineers; and the Bureau of Indian Affairs. Taken together these agencies control an alcohol distribution network that exceeds, both in land area and in population affected, the jurisdiction of any single state ABC. Problems associated with alcohol constitute at least See note 2 above.

394 MOSHER and MOTTU a minor concern of the agencies and all have adopted at least some regulatory provisions in an attempt to cope with them. By far the most important of these agencies and departments is the Department of De- fense, which has, through the various armed services, adopted extensive regulations and experimental programs. These agencies may have concerns with alcohol problems ancillary to their distribution jurisdiction, such as treatment or rehabilitation pro- grams for employees or safety regulations to protect citizens, some of whom may be in danger because of drinking (e.g., regulatory access to fire danger areas to limit the danger of accidental forest fires). However, one of their primary duties is to administer jurisdiction over the everyday activities of a particular area, and this study examines their decisions concerning alcohol use and distribution as one aspect of this primary duty. As discussed in the introduction to this section, the alcohol distribution network has been put under scrutiny as a possible tool for preventing alcohol-related problems. Federal policy has not previously been ex- amined in a systematic way. The activities of the Defense Department, because of its scope and importance, are discussed last and in some detail. Following an analysis of the scope and exercise of each agency's authority is a discussion that focuses on the Navy and potential areas of reform that could benefit from a uniform federal policy to prevent alcohol-related problems. NATIONAL PARK SERVICE Jurisdiction over most National Park Service areas (as is jurisdiction over all areas managed by the Forest Service, the Army Corps of En- gineers, and the Bureau of Land Management) is shared by the federal and state governments. Older, larger parks are under exclusive federal jurisdiction, although state law may apply in specific circumstances. Because of its flexibility, concurrent jurisdiction is generally favored by National Park Service officials. The National Park Service maintains 320 areas, and in 1978 283 million people visited park lands. There are 400 park concessions, of which 151 sell alcoholic beverages, and sales from these reached $5.8 million in 1978, which was 3 percent of total concession sales. These figures do not include alcohol carried in by visitors the National Park Service has no estimates concerning the extent of this practice. The National Park Service regulates the sale and use of alcohol in all of its park areas through several regulations: (1) a prohibition on op-

The Role-of Nonalcohol Agencies 395 crating a vehicle or vessel while intoxicated or under the influence of alcohol; (2) a prohibition on being so intoxicated as to endanger oneself, others, property, or others' enjoyment of the park; (3) a prohibition on the sale of alcohol to or possession of alcohol by a person under 21 years of age, unless state law permits otherwise; (4) a requirement that a permit from the regional director be obtained before the sale of alcohol can be made from privately owned land within large parks; (5) a re- quirement that licensees conform to local and state law as if the land on which they operate were located outside the park area. The pricing of alcohol is subject to National Park Service approval and is judged primarily by comparison with similar facilities under similar conditions (e.g., length of season, accessibility, cost of labor, and type of pa- tronage). BUREAU OF LAND MANAGEMENT The Bureau of Land Management manages nearly 600 million acres of federal land, which includes much desert and Alaskan wilderness as well as forest and water areas. Concessions operate in some areas and a fair percentage of these sell malt liquor. Exact figures are unavailable. The bureau exercises no control over these beverage sales. It issues no li- censes and levies no franchise fees. The bureau relies heavily on local law and law enforcement, and there are no provisions relating to alcoholic beverages in its regulations. How- ever, it does regulate numerous other activities on bureau lands. These include prohibitions against the use of audio devices (any machine that makes noise), restrictions on vehicle operation, prohibitions against pets in certain areas, and other prohibitions deemed necessary to protect the interest of public health, safety, and comfort. Thus, it clearly has juris- diction to regulate alcohol-related problems on these lands if it chooses to do so. However, its enforcement staff is very small in relation to its area of jurisdiction. Few data are collected; thus, the level of alcoholic beverage con- sumption within its lands, the volume sold from its concessions, and the connection of alcohol use to accidents or vandalism are unknown. ARMY CORPS OF ENGINEERS The Army Corps of Engineers maintains concurrent jurisdiction over 457 water projects and 4,200 recreational areas. It leases about one-half of the recreational areas to state and local governments.

396 MOSHER and MOTTE Prior to 1971, by departmental directive, the corps prohibited the sale and storage of all alcoholic beverages within its areas. Changes were made, however, in response to local, state, and congressional pressure. The corps now has a more flexible policy regarding alcoholic beverages. The present directives, which are in the process of revision, prohibit the sale or storage of alcoholic beverages except in areas where it is a custom and where it is permitted by state law. The express purpose of this restriction is to preserve a family atmosphere on recreational lands. Where sales are permitted, concessions may sell beer and wine for off- premise consumption. On-premise sale of distilled liquor is permitted when it accompanies dinner at lodges and hotels. Corps officials stated that information concerning the number of areas that have chosen this option was not readily available. The corps maintains statistics on fatalities and accidents in their areas, but irregularities in reporting methods and recordkeeping among the states and counties make the accurate maintenance of alcoholic beverage variables impossible. Federal law provides funding for enforcement in these localities, without which many areas would be unable to carry out such activities independently. However, cooperation in enforcement between the corps and local officals is strictly informal and loosely co- ordinated. NATIONAL FOREST SERVICE In 1978, 218 million "visitor days" were spent in the 104 national forests, where alcoholic beverages are served in approximately two-thirds of the 625 resort areas. No official figures are available on the number of outlets or on sales volume. The National Forest Service exercises some control over alcoholic beverages by issuing lease-permits to concession operators, which are subject to special conditions. Forest service policies prohibit the off-premise sale of distilled liquor. On-premise sale of all liquor is permitted in facilities, provided they are part of a legitimate resort activity or service. Sale of malt beverages is left to prevailing local laws and customs. According to one official, the arrangements are intended to be as flexible as possible' and local and state governments carry out most law enforcement under the concurrent . . .. . JunsUlctlon. Despite the numerous research projects the National Forest Service maintains, we found no research being conducted to determine the level of alcohol use in forest areas and its connection with forest fires, unex- tinguished camp fires, or damage within forest areas.

The Role of Nonalcohol Agencies BUREAU OF INDIAN AFFAIRS 397 The federal government, by constitutional provision, has exclusive ju- risdiction over all native American reservations. This authority may be delegated to tribal councils, and often is. Because of the federal trust obligation to the tribes, the government may not delegate any of its powers to the states without tribal consent. The Bureau of Indian Affairs (BIA), a part of the Department of the Interior, was established to administer federal responsibilities to the tribes. The federal government and the BIA, pursuant to this general grant of power, established exclusive jurisdiction over the sale and possession of alcohol on reservations as early as 1802.5 In that year, the president was given the authority to ban sales of alcohol on reservations. From 1802 to 1953, alcohol regulations became increasingly restrictive, ban- ning all possession and distribution and making violations of alcohol laws grounds for extended prison terms and denials of treaty annuities. As has been documented elswhere (Mosher 1975), the history of increasingly stringent BIA alcohol control laws has been a history of symbolic measures that had little relationship to genuine concern with native American alcohol-related problems. During the 19th and much of the 20th century, violations of alcohol laws were extensive, fueling a vigorous bootlegging trade. The BIA did little to deter this illegal but profitable trafficking, although selective enforcement against tribal members who purchased from bootleggers could lead to serious con- sequences for the tribe and the individual. In 1953, the BIA voluntarily lifted its ban on possession and distri- bution on those reservations on which tribal councils decided to assert their own authority. In effect, the new regulation turned over authority to regulate alcohol to the tribes. This move was not a signal of increased tribal autonomy, however. Rather, it was part of a move to detribalize the reservations, to promote integration of native Americans into the American mainstream, and to delegate authority to the states. Detri- balization did in fact occur in several states, and the BIA's change of alcohol policy there signaled the beginning of state authority. Detri- balization was fiercely opposed, however, and was eventually largely abandoned, although authority to control alcohol distribution has re- mained with the tribes. 5 The statute provided (act of March 30, 1902, ch. 13 ~ 21, 2 Stat. 139~: The President of the United States (is) authorized to take such measures from time to time. as to him may appear expedient to prevent or restrain the vending or distributing of spirituous liquors among all or any of the . . . Indian tribes.

398 MOSHER and MOTTE Tribal regulation of alcohol is extremely varied, depending on tribal norms concerning alcohol (May 1977~. The variations are too extensive to be summarized here. It can be assumed that any attempt by the BIA to reassert its authority in this area will be violently opposed by the tribes as signaling unwarranted federal intervention into tribal affairs. DEPARTMENT OF DEFENSE The armed forces have an extensive network of alcohol beverage sales; it is sufficiently large to make them one of the most important retailers in the country. They also act as regulators and, because of the size of the sales network, can be compared to ABC boards in the various states. The federal government has exclusive jurisdiction over all alcohol sales within military reservations. Thus, state law does not apply. All three service branches have regulations to encourage local commanders to cooperate with local officials in matters pertaining to alcohol beverage sales, but the regulations state specifically that the armed services are not subject to local control.6 Alcohol sales at military outlets are there- fore exempt from state and local taxation. The Department of Defense alcohol outlets serve some 8 million people- 2 million active members, 3 million dependents, 1 million ci- vilians, and 2 million national guard and reserve members (Killeen 1979~. Over one-half of active members are under 25 and 40 percent are single which means that the major customers of military sales are precisely those within one of the current NIAAA target groups (Killeen 1979~. In sum, the armed forces' policies on alcohol sales have a major impact on the country, and they must be included when discussing policy issues concerning the regulation of alcohol availability. All three services (the Army, Navy, and Air Force the Marines are not included in this paper) operate both on-premise and off-premise outlets. The club (or open mess) system, a major component of the military's recreational services, provides the primary on-premise outlets. It sells all types of alcoholic beverages for consumption on the premises and sells beer for off-premise consumption. The Air Force has 320 open messes worldwide, which had a total volume of alcohol sales of $61.9 million in fiscal 1977; the Navy operates 311 clubs, which had a total volume of $49.5 million; and the Army has 654 on-premise outlets world- wide (304 within the United States), which had a volume totaling $68 6 Because federal agencies (except the BlA) could voluntarily relinquish authority over alcohol distribution to the states, this qualification may have been deemed necessary to ensure that federal control over disputes is retained.

The Role of Nonalcohol Agencies 399 million. (The Army totals include sales of peanuts and popcorn; alcohol sales themselves are not broken down further.) In addition, all services provide some additional on-premise outlets. Beer, and in some cases other alcoholic beverages, may usually be sold at bowling alleys, dining halls, and recreational centers during special activities. The Air Force permits beer vending machines in dormitories in some cases and permits the sale of 3.2 (low alcoholic content) beer in several facilities. All three services operate package stores. The stores sell all types of alcoholic beverages and may or may not be found in conjunction with post-exchange stores. The network is extensive: the Army operates 200 stores, which had a total volume of alcohol sales of $119 million in fiscal 1977; the Air Force operates 163 stores, which had a volume of sales totaling $72.9 million; and the Navy operates 111 stores, which had sales amounting to $84.8 million. The total of $276.7 million in package store sales is about 75 percent of the total of $356.1 million in alcoholic beverage sales for the service in fiscal 1977 figures that are equivalent to or exceed many state sales figures. Since these figures derive from discount pricing policies (see below), the volume of beverages sold by the services is even higher than indicated by these figures. (The military statistics for quantities sold were not available.) The package stores are managed by the clubs, and most profits from the stores are plowed into the club system. The club system, in addition to running bars, provides various forms of related recreation and en- tertainment. The Government Accounting Office (GAO) reports that the package stores had a net income of $51.4 million in fiscal year 1977, of which $34.8 million was distributed to the clubs (Comptroller General of the U.S. 1979a). Many of the clubs operate at a deficit, and the package store profits are used to make up the difference. According to a recent GAO report, this policy has led to problems of mismanagement in the clubs, as there is little incentive to cut costs (Comptroller General of the U.S. 1979a). Restrictions on Availability All three services enforce mandatory age limits on drinking (prohibiting the sale to, purchase by, or consumption of alcohol by those under a specified age). The Army and Air Force permit 18-year-olds to drink unless the state, country, or territory in which the club or store is located enforces a different age limit. (Army regulations permit local com- manders to decide whether 18-year-olds may drink beer regardless of local law.) The Navy permits 18-year-olds to purchase beer (if not con-

400 MOSHER and MOTTL trary to local law) but prohibits those under 21 to purchase other al- coholic beverages. The Air Force recently amended its regulations to permit I8-year-olds to purchase and consume beer at Air Force outlets regardless of local law.7 The services also attempt to restrict the resale of alcoholic beverages by the purchaser. As discussed below, military alcohol sales are generally much less expensive than civilian sales. Proper identification must be shown prior to any sales, and in the Air Force the purchaser must sign a sworn statement that the purchase is for personal use only. Local commanders are directed to oversee the per-capita consumption of au- thorized personnel (i.e., compare sales figures with total personnel per- mitted to purchase) in order to determine whether unauthorized sales and resales are occurring. Other regulations of drinking behavior concern specific consumer activities. These include restrictions on where consumption or possession may occur (e.g., no possession in recreation centers and craft facilities unless in conjunction with special programs; prohibition of open con- tainers in any automobile). Perhaps the most important of. these restric- tions is the Navy prohibition of any alcoholic beverage consumption aboard planes and ships. Deglamorization Program Until recently, the prohibitions described above were the major restric- tions placed on alcohol availability. However, as the Defense Depart- ment has become more aware of the degree of alcohol-related problems found among its personnel, it has taken a serious look at availability. During the last 7 years, it has instituted "alcohol deglamorization" pro- grams, which are found in all three services. Most of the program com- ponents rely on cooperation from the particular services and the local commanders. The department is now preparing a directive to require or recommend many additional reforms. (Unfortunately the contents of the directive were not available in time to include in this paper.) The chief components of deglamorization are summarized as follows: (1) Restrictions on reduced-price drink periods Happy hours). These restrictions include limits on the number and length of happy hours; 'It is remarkable that there has been so little contact between NIAAA and the military prevention programs, at least on this point. NIAAA' which has become very concerned with the age-group most prominent in the armed services, has considered opposing the lowering of the drinking age in various states. Yet the recent moves by the Air Force to lower beer availability to those 18 years of age regardless of state law was not even commented on by NIAAA.

The Role of Nonalcohol Agencies 401 requirements that snacks and food be served and that soft drink prices be reduced an equivalent amount; and prohibitions on excessive reduc- tions of price. (2) Prohibition of certain serving practices. These include prohibitions on: stacking drinks; two-for-one sales; free drinks; "last call" or count- down sales techniques; service of doubles without an appropriate in- crease in price; the inclusion of alcohol in the price of meals; and the service of intoxicated persons. On-premise outlets are encouraged not to begin service until noon and to do so only in conjunction with a noon meal. Nonalcoholic beverages must always be available. (3) Regulations of base operations. When possible, family-oriented facilities must be provided that are not centered around the service of alcohol. Alternative recreational facilities should be available during the club's operating hours. The Air Force also provides that "special atten- tion and creativity" should be given to developing and promoting non- alcoholic drinks and food and that amusement machines and "diver- sions" should be available. (4) Other deglamorization policies. Deglamorization usually includes general policy statements concerning the expectation of moderate drink- ing; the expectation that personnel will refrain from drinking before or during working hours (with the exception of moderate drinking during a meal); and restrictions on club advertising. The armed forces also offer training to club personnel who actually serve patrons. Information concerning this training was not available in time for this paper. The various deglamorization provisions vary from service to service and are mostly voluntary, although some are mandatory. Their imple- mentation is left largely, if not entirely, to the discretion of the base commanders, who are often given power to make specific exceptions. Moreover, there has been considerable resistance to the policies, par- ticularly from club personnel. The clubs do not want to lower their income, since they operate on nonappropriated funds and are expected to break even. Alcohol sales (both at the clubs and at the package stores) make up a large part of their profit margin. There has been no effort to ease this financial strain in conjunction with the deglamorization program. As a result of these factors, deglamorization has not been instituted on a large scale. Because of the various exceptions and loopholes in the regulations, most base commanders have either ignored the policies or have given only marginal support to them. A GAO report on military alcohol abuse programs found only isolated instances of compliance (Comptroller General of the U.S. 1976a). The report states (p. 31~:

402 MOSHER and MOTTL Many military installations we visited had not taken any action to Reemphasize and discourage alcohol use. We found that (1) hard liquor was sold freely at noon in base clubs, (2) happy hours were widely advertised, (3) drinks were on sale at 25¢ apiece, (4) special low prices on "dnnk of the week" were provided, and (5) free bottles of champagne were given on individuals' birthdays. [The practice of providing free birthday drinks is specifically permitted in the Air Force and Army regulations.] We also found instances where special committees recommended discouraging alcohol consumption by reducing happy hours at base clubs or reducing the number of drinks for each individual; however, command personnel rejected these recommendations as too severe or unnecessary. GAO personnel report that in general the status of deglamorization remains the same today. A survey conducted by GAO for another report supports this: 20 percent of military personnel were unaware of the deglamorization program; 60 percent did not change their drinking hab- its at all; 10 percent reported decreases in consumption; and 4 percent reported increases in consumption (Comptroller General of the U.S. 1979b). The Defense Department, in conjunction with deglamorization pol- icies, instituted guidelines for determining the necessity of new package stores. The criteria to be considered include: (1) the estimated number of customers; (2) the importance of estimated contributions of package store profits to providing, maintaining, and operating clubs and other recreational activities; (3) the availability of wholesome family social clubs to military personnel in the local civilian community; (4) geo- graphical inconveniences; (5) limitations of nonmilitary sources; (6) po- tential disciplinary and control problems due to local law and regulation; (7) highway safety; (~) community response. The actual enforcement of these guidelines is difficult to determine. For our purposes it is in- teresting to note that both economic factors and factors relating to alcohol-related problems are included. Pricing Policies The Defense Department has promulgated a directive that requires that sales of alcoholic beverages in package stores cannot be less than 10 percent below the lowest prevailing rates of civilian outlets in the area. Exceptions may be granted, but only by approval of the secretary of the particular service after a substantial showing that special factors warranting an exception are present. Determining actual prices is suprisingly difficult, given this seemingly

The Role of Nonalcohol Agencies 403 elementary policy. First, the lowest available price in the area must be located. In license states, this may vary widely, particularly in urban areas. The Army regulations define a local area as any place within 25 miles or 30 minutes' drive from the military installation. Local and state taxes are not included in the price computation, which, in many states, means an additional 5 percent or more discount. GAO officials report that this tax exemption is used in monopoly states as a means to exclude state store overhead and profit margins (which are viewed as a type of tax). Defense Department personnel deny this. The Air Force and Army have recently deleted this minimum price requirement altogether with regard to beer. DISCUSSION Several observations can be made concerning federal land-based control of alcohol distribution: (1) a great volume of alcohol is sold under the auspices of the federal government in a variety of settings and types of establishments; (2) authority to regulate sales is widely dispersed and generally ignored, except in the Defense Department outlets, where sales are often encouraged; (3) the relationship of alcohol sales and use on federal lands to potential risks is generally ignored; and (4) there is virtually no contact between federal agencies with authority to regulate retail sales and those agencies charged with formulating federal policies toward alcohol use and abuse. Other than Defense Department agencies and the BIA, there appears to be little expectation of major changes in current attitudes, at least in the absence of congressional action to force policy initiatives or to centralize alcohol distribution authority—equally unlikely prospects. Agencies such as the National Forest Service simply do not consider alcohol distribution and problems as part of their mandate. The tendency to turn over responsibility to private parties in accordance with rules of local jurisdictions is both convenient and understandable. Despite these impediments, some minimal proposals could prove to be fruitful. Some agencies still maintain restrictions on availability (such as the National Forest Service's ban on off-premise distributions. Recent studies have documented the increasing availability of alcohol in an expanding number and types of settings (Douglass and Freedman 1977, Mosher 1979b,c), and other studies have suggested that there may be a link between increased availability and drinking problems (e.g., see Bruun et al. 1975~. These studies suggest that the agencies should be encouraged to maintain current availability policies rather than to con-

404 MOSHER and MOTTL tinue market expansion, at least until the relationship between availa- bility and alcohol-related problems is better understood. Contacts with these agencies suggest that the only pressure they receive concerning alcohol distribution is for continued expansion. Providing some coun- terbalance to this trend, which would entail minimal costs, would appear appropriate, at least on a symbolic level. The BIA presents a special case because of its unique position vis-a- vis the native American tribes. The competing interest in delegating authority to tribal councils (authority that is jealously guarded) appears to outweigh the potential benefits of reasserting BIA alcohol control policies, particularly given the BIA's dismal history of control prior to 1953. This does not rule out the possibility of providing advice to tribes that are instituting changes in their own control system or that need assistance in coping with alcohol-related problems. Programs along the lines suggested below regarding the military might be appropriate for funding. The Defense Department appears to provide better opportunities for experimentation and change. Unlike the other agencies studied, the military has, in the last 9 years, commissioned outside studies and in- stituted major new programs to determine the extent of alcohol problems and to combat them among its service and civilian personnel (Cahalan et al. 1972, Cahalan and Cisin 1975, Comptroller General of the U.S. 1976a, Killeen 1979, Long et al. 1976, Manley et al. 1979, Polich and Orvis 1979, Schuckit 1977~. Alcohol is now recognized as a serious problem that affects a large percentage of military personnel an im- portant development in Defense Department attitudes. According to Killeen (1979, p. 356) there were virtually no efforts to deal with alcohol abuse prior to 1965 and only small-scale programs between 1965 and 1971. Increased interest in and concern about alcohol abuse has provided an impetus to examine the network of military alcohol distribution. As the deglamorization guidelines suggest, Pentagon officials recognize that practices of service tend to encourage problem drinking and to obstracize nondrinkers. Although the GAO and our own inquiries suggest that deglamorization directives have had only minimal impact at most local bases, the interest in controlling availability as a means of controlling alcohol problems is unusual (if not unique) among alcohol control agen- cies, including state ABCs. Various local naval stations as well as officials at the Pentagon were contacted during the course of this study to evaluate the potential for policy reforms concerning alcohol marketing within the military. The Navy was chosen because, of all the services, it has shown the most

The Role of Nonalcohol Agencies 405 concern and enthusiasm for instituting prevention programs. In addition, naval personnel have a reputation for heavy drinking. Survey data show that the Navy does indeed have serious alcohol problems among its personnel. The Navy issued a report in 1975 con- cluding that 39 percent of enlisted personnel and 23 percent of officers had drinking problems described as "critical," "very serious," or "se- rious" (Cahalan and Cisin 1975; also reported in Comptroller General of the U.S. 1976b). The study also found that 27.4 percent of enlisted personnel and 22.4 percent of officers reported at least some lost work time or work inefficiency during the 6 months preceding the study due to drinking. The figures for enlisted personnel (who represent the heav- iest drinkers generally) are substantially higher than comparable figures for civilians in the same age bracket. The GAO cited an additional study substantiating Cahalan and Cisin's findings. The Naval Air Training Command in 1974 issued a report that found that 32 percent of officers and 37 percent of enlisted personnel have had drinking problems. That report concluded that alcohol was the primary drug problem among naval personnel (Comptroller General of the U.S. 1976b). The Navy fully recognizes and publicizes the alcohol problems among its personnel. A military-sponsored magazine recently published an ar- ticle providing statistics on naval alcohol problems that were obtained from the Navy (Fowler 1979~. According to the article, of the approx- imately 540,000 naval personnel, there are currently 200,000 problem drinkers and 80,000 alcoholics; excessive drinking costs more than $189 million in poor job performance. As a measure of particular alcohol- related problems, approximately 3,000 of the 12,000 drunk drivers ar- rested in San Diego annually are Navy and Marine Corps members. The article also notes that costs to the society generally are high in terms of both drunken driving accidents and discharged alcoholics. The publicity concerning these alcohol-related problems can be viewed as part of the Navy's attempt to address directly the issues in- volved. Our contacts with naval officials found that the recently insti- tuted Naval Alcohol Safety Action Program (NASAP) is enthusiastically endorsed at all levels. NASAP is a prevention-oriented effort that began in 1974 as an adjunct to other, more treatment-oriented programs. It is specifically designed to promote the early identification of alcohol problems and expanded education and publicity campaigns. NASAP officials claim that a 25-percent increase in work effectiveness will occur if NASAP programs are established on local bases. An installation has been established at San Diego with the express purpose of training counselors and advisors to work in NASAP programs around the world. Without evaluating NASAP claims of success, one can still note that

406 MOSHER and MOTTL a major change in attitudes has occurred. High-level and middle-level officers, who until recently ignored alcohol abuse, now support the concept of NASAP. Moreover, participation in NASAP programs is becoming a more accepted alternative for personnel and is less stig- matized. Naval officials stress that its management is more centralized and prevention-oriented. Thus the NASAP's prevention focus is more easily accepted than in other services. NASAP has not embraced deglamorization regulations concerning service practices or pricing reforms in off-premise outlets as an integral part of its program. The program serves an advisory role and will rec- ommend deglamorization guidelines for administering clubs and stores when requests are made. Part of this reluctance comes from the resist- ance to deglamorization, which is common in all military services. A1- though local officials in general stated that they supported deglamori- zation, a Pentagon official gave a different view, which has been confirmed in contacts with other military branches. The enlisted per- sonnel resent changes in club procedures as just another imposition from supervisors. Significant changes cause defections by regulars, particu- larly those with the worst problems, to off-base establishments. Finally, the financial arrangements, whereby alcohol sales help pay for other club activities, create a lack of interest at the local level. Despite this lack of enthusiastic support, all persons contacted agreed that at least some bases have instituted some or all of the deglamorization policies. Bases with transient populations, particularly those that receive personnel from ships that have been at sea for extended periods, are less likely to comply because of opposition by patrons. Bases with stable populations, however, have a higher compliance rate. We were unable to determine levels of compliance except through random contacts. Compliance is dependent on local commander initi- ative and there is no centralized method for reviewing local decisions. Three base representatives contacted in the San Francisco Bay area told us that the deglamorization policies were being followed. Independent observation evaluation has not been conducted to determine the accu- racy of the representatives' claims. It is our conclusion that certain policy initiatives within the Navy concerning services and selling practices would receive at least some support at all levels and could serve to build more extensive contacts and changes. The following initiatives are suggested: (1) A concerted effort to reform the financing of alcohol sales. The GAO and Congress have both been active in attempting to divorce alcohol profits from club-related recreation and to raise off-premise

The Role of Nonalcohol Agencies 407 prices to reflect costs outside the based As the above discussion shows, there are essential elements in promoting deglamorization policies. The concept of the self-supporting club has emerged historically without any awareness of the problems it raises in promoting excessive alcohol use and abuse. It may have reflected a congressional sense that funds for purely recreational expenditures should not be made available.. But promoting alcohol sales can be argued to be a false funding source— excessive alcohol use creates hidden costs for both the Navy and society, costs that have already been recognized by the Navy. Today, adequate recreational facilities associated with military clubs can be justified, and funding does not need to be dependent on alcohol sales. Divorcing alcohol sales from club-related recreation would diffuse opposition to deglamorization programs at the local level because a necessary serv- ice~lub-related recreation would not be put in jeopardy. The profits from alcohol sales could go to the federal treasury, or they could be redirected to the NASAP program (a suggestion given by a NASAP official); independent funding could be provided for clubs and recreational activities. This would involve alcohol profits in a pro- gram that has expressed an interest in implementing deglamorization and other prevention programs, a program that justifies its existence in part by decreasing the cost of alcohol abuse and alcoholism. However, it runs the risk of creating new vested interests in alcohol profits. Raising the package store price for alcohol also provides a promising strategy for aligning the military's alcohol sales authority with its interest in reducing alcohol problems. In addition to the GAO findings, anec- dotal reports indicate that discounts may be much more substantial than those authorized by the Defense Department. Package store sales are subject to large discounts, which encourage unauthorized sales and re- sales. Providing the cheapest off-premise alcohol within a 50-mile radius is an obvious invitation for abuse and for possible drunken driving. Following this strategy does not mean that providing discount pricing as a benefit to enlisted personnel should be abandoned. The discounts x According to a recent United Press International release (reported in the San Francisco Chronicle, March 3, 1980. p. 18). a congressional panel of the House Armed Services Investigators Subcommittee has strongly criticized current practices. Panel chairman Dan Daniel stated that the panel has issued an ultimatum to the military that by the beginning of fiscal 1981 the package store profits should not be used to subsidize the military clubs and instead should be used for general morale. welfare and recreational activity. The recommendations here differ somewhat from the panel s concern. The panel would use alcohol profits to support other recreational activities. such as gymnasiums rather than to support clubs. Our suggestion would be to divorce alcohol profits from recreation completely and to put the funds into the general treasury or into alcohol-prevention programs.

408 MOSHER and MOTTL could be transferred to essential items so that nondrinkers are not pen- alized. It should be noted that local alcohol retail businesses would probably welcome a change in this unfair government competition. Pricing of on-premise alcohol is not subject to any regulation except the mainly voluntary restrictions found in the deglamorization program. A GAO study of military clubs shows that low prices for drinks and special discount policies are one of the prime incentives for military patronage of clubs, particularly among men (Comptroller General of the U.S. 1979a). Slightly lower prices in clubs may be justified to en- courage patronage in order to monitor more carefully the drinking con- text and to deter drunken driving off base. In fact, having other non- drinking entertainment and services may provide the same benefits. However, these factors do not justify the use of sales techniques, such as free drinks, stacking drinks, etc., that encourage excessive drinking rather than patronage. (2) Establishing and evaluating various server reforms. The degla- morization guidelines are really methods to influence drinking contexts, and very little is known about the relationship of drinking contexts to drinking problems. Thus, the Navy's efforts in this area are extremely important as sources for potential experiments. Implementation across the board is probably neither practical nor advisable. In some clubs, such as those catering to sailors who have been at sea for months, many of the reforms could be counterproductive. However, limited experi- mentation with careful evaluation (of both the type of reform and type of establishment) would be very valuable to the field. As results are understood, adjustments could be made and programs could be ex- panded. In addition, recent programs to train servers to recognize problem drinkers and to institute various reforms to ensure that patrons do not become drunken drivers could be funded and evaluated (Mosher and Wallack 1979, Mosher 1979a). Many of the reforms in a recent California experiment, conducted by the California Alcoholic Beverage Control Department, are along the lines of the deglamorization guidelines (Mosher and Wallack 1979~. It should be emphasized that there are virtually no programs in the country in which governmental bodies are attempting to institute reforms in serving practices with a preventive orientation. The potential prob- lems of dealing with military personnel, given the command structure's endorsement of prevention as a part of their military duties, are much smaller than the obstacles to instituting similar reforms in civilian life, where alcohol control authorities do not in general acknowledge pre- vention as within their sphere of concern. Evaluation of the Navy's

The Role of IVonalcohol Agencies 409 efforts and encouragement for continuing and expanding efforts is there- fore important. Support would be enhanced by promoting these changes as part of the NASAP program. There was at least lukewarm support for such a tactic. Sunnort could also be established by minimizing costs and op- pos~t~on beginning with procedures that do not directly deny drinks to nonintoxicated patrons and that do not directly threaten funding. Much of the effort could be geared toward attitude change, a slow process, but one that is already occurring in the NASAP program. Emphasis could be placed on the fact that some current practices (stack- ing drinks, drinking contests, etc.) actually encourage drinking, which certainly creates a reasonable suspicion that they contribute to drinking problems. Deglamorization creates a neutral attitude toward sales and will tend to reduce the costs of alcohol problems both for the Navy and for society as a whole. FEDERAL SAFETY-BASED JURISDICTION OF ALCOHOL-RELATED PROBLEMS INTROD UCTION The History of Safety Regulation One of the most expanding aspects of federal jurisdiction during this century concerns regulatory efforts to enhance the safety of our envi- ronment. Although the 19th century witnessed the growth of safety- related inventions (such as the safety pin and safety match), safety was considered an individual's responsibility. The concept of "contributory negligence" in legal cases reflected this view—one could not recover for injuries caused by another person's carelessness if it was shown that the person injured contributed in any way to his or her own injury. Safety as a federal concern began in the first decade of this century. Initially, governmental action was prompted by the use of dangerous additives in foods. The Pure Food and Drug Act was passed in 1906 in an attempt to protect citizens from adulteration and fraud by food pro- cessors. The rationales for governmental intervention, which are still relied on in part today, were that the consumers are unable to protect themselves from deceptive industry practices, and the dangers were so great that federal action was warranted. Other national initiatives to promote safety soon followed. In 1931, the National Safety Council was formed as a private agency. Its purposes included the promotion of safety throughout the country and the com-

410 MOSHER and MOTTL pilation of data concerning various societal risks. The Food and Drug Act was expanded several times; agricultural and public health chemicals came under government scrutiny in 1947. By the late 1960s there was a proliferation of safety agencies to perform the tasks taken on the Occupational Health and Safety Administration (OSHA), the Consumer Product Safety Commission (CPSC), the Federal Drug Administration (FDA), the Environmental Protection Agency (EPA), the National Highway Transportation Safety Administration (NHTSA), the Nuclear Regulatory Commission (NRC), and the National Transportation Safety Board (NTSB). The Coast Guard and the Bureau of Mines, among other federal agencies, were given expanded safety responsibilities. The federal concern for safety has made our society much safer than it was at the turn of the century in at least some regards. Working conditions in many industries have become much less hazardous; dan- gerous pesticides and canning chemicals have been banned; the number of fatal accidents (including automobile deaths) has been reduced by nearly one-half proportionate to the population. The life expectancy of Americans has risen dramatically partly because of government's em- phasis on enhancing safety. However, technological solutions have themselves created risks. To- day's transportation network creates numerous dangers on the ground, in the water, and in the air. Our increasing dependence on chemicals and nuclear technology creates great risks that cannot be measured. Many of our modern risks tend to justify government action for the same reasons that the trend toward federal intervention began—con- sumers cannot effectively protect themselves against the dangers, and the risks may be potentially very great. The activities of the various safety agencies, then, have become a crucial part of the government's role in serving and protecting its citizenry. The move toward increasing the government's regulatory safety pow- ers has not been without debate, however. While reducing potential risks of harm may be" a proper goal for government, providing over- protection has its own social costs. Individual freedoms may be jeop- ardized; creativity, both of individuals and of business, may be stifled; the viability of small businesses may be eroded by the prohibitive costs of safety requirements. Determining when and how to intervene to promote safety, then, is an important topic of current federal practice. Lowrance, in his groundbreaking study, Of Acceptable Risk (1976)- one of the few efforts to broach this topic discusses two discrete issues that have to be addressed before deciding to regulate a potentially risky activity. First, the risk must be measured. This is a largely factual inquiry,

The Role of Nonalcohol Agencies 411 and Lowrance describes the various methods for measurement. It also includes determining the causal factors that contribute to particular in- juries. Second, the acceptability of risks must be determined. This is a policy decision, and it requires the balancing of social values. One aspect of this policy analysis includes determining which causal factories) should be manipulated if government action is warranted.9 The choic~of which factor to regulate and what level of safety is necessary are difficult, political decisions. In addition to protecting the safety interests of consumers, safety agencies must also balance com- peting industrial interests. Often, the industries' interests themselves will be in conflict, as the available strategies for reducing risks will have different financial impacts on different industries. Lobbying pressure may become intense, as those being regulated seek to influence and direct the actions of the regulators, often by obtaining friendly appoint- ments to key administrative positions. Powerful industries may seek congressional action if they perceive that a particular safety agency has become overzealous. Thus, despite our increasing emphasis on safety, the political forces that affect the decision-making process create a dan- ger that the decisions will reflect political rather than safety concerns. The experience of the Consumer Product Safety Commission, described below, illustrates the political problems that may affect the role of safety agencies. Alcohol as a Factor in Safety Regulation One fact that appears repeatedly in a variety of accidents of concern to safety agencies is the role of excessive drinking. It is well recognized that excessive drinking contributes to most common accidents travel, employment, recreation, and home injuries (Aarens et al. 1977~. Un- fortunately, the extent of alcohol involvement is not well documented primarily because the agencies responsible for reducing risks in partic- ular situations and compiling statistical data do not analyze alcohol 9 William Haddon (1973a~b) has developed a set of 10 strategies for reducing "energy damage," a term he coined to include both accidental and intentional damage to persons and property. These strategies are based on an analysis of the "processes'' that typify occurrences causing harm and identifying different possible points of intervention. Al- though it uses different terminology, Haddon's approach is parallel to the one discussed here—several different prevention-oriented interventions can be suggested by analyzing the various factors that contribute to an accidental occurrence and that cause unwanted harm.

412 MOSHER and MOTTL casualty in any consistent or thorough way. For the most part, federal safety agencies do not consider alcohol as part of their jurisdiction. Alcohol policy makers, in turn, have ignored safety agencies as po- tential allies in reducing alcohol-related problems (except, arguably, for automobiles) because only one strategy is used~hanging drinking be- havior. Most commonly, alcoholism is viewed as the problem to be addressed, and treatment and rehabilitation programs for alcoholics are relied upon.~° When safety agencies and alcohol policy makers do co- ordinate activities, alcoholism programs are virtually the exclusive strat- egy employed. These programs have proven to be of only limited value in reducing risks, however, because alcoholism treatment is not a very specific policy instrument for changing drinking behavior in particular situations (e.g., before driving a car). Moreover, many drinking-related accidents have been found to be unrelated to alcoholism. The failure to judge the role of alcohol in accidents and to study potential strategies to reduce its effect in risk situations has denied prevention strategists a potentially valuable tool. As Lowrance suggests (1976, p. 59), there may be other causal factors in a given situation that, with appropriate action, could be manipulated to reduce the risk of harm. By doing so, alcohol-related accidents could be reduced without any change in actual drinking behavior. This suggests that the activities of various federal safety agencies may be crucial in the effort to prevent alcohol problems. It also suggests that prevention strategies may involve attempts to change political priorities in regulating particular risky ac- '° See the section on federal transportation-based jurisdiction below regarding the Federal Railway Administration and the Federal Aviation Administration (FAA) for examples of this type of liaison. OSHA. while not studied in detail here, was found to have the same emphasis. There are some safety agencies that, because of the extent of potential danger. cannot tolerate any drinking or alcoholism in certain situations, for example, the FAA (discussed later in this paper) and the Nuclear Regulatory Commission (NRC). The NRC permits dismissal of any personnel with security clearances when he or she is found to be `'a user of alcohol habitually and to excess and has been without adequate evidence of rehabil- itation." Security guards must have a general health examination prior to employment and prior to renewal of licenses. Other employees do not receive any medical screening, and there are no regulations concerning drinking on the job. The potential dangers associated with nuclear reactors would appear to justify more awareness of alcohol's potential harmful effects on employees. A newspaper report pub- licized an incident in Oregon in which security guards were found dealing in drugs on the job site. In partial response, the NRC announced it will require checks for alcohol addiction among all security guards beginning in March 1980. As the NRC experience illustrates, safety agencies may have the power to regulate the availability of alcohol in particular situations. Transportation-based agencies with such dual powers are discussed in the section on federal transportation-based jurisdiction.

The Role of Nonalcohol Agencies 413 tivities. Aarens et al. (1977, pp. 600, 602) summarize the new direction being suggested: Research can be used to find manipulations of the environment which will reduce alcohol-related casualties and crimes. In our view this is at once the most ne- glected and the most promising use for research. It requires painstaking and detailed studied serious events with attention to the occurrence and sequencing of contributing factors and to potential strategies of prevention or intervention. It is not at all oriented around the quick and easy single figure of alcohol's involvement in the event.... The common assumption in consumer product safety research is that, except for children and disabled persons, the consumer is in full command of his mental and physical faculties in using the products tested. No recognition is given to the fact that the products will at least occasionally be used by consumers in an inebriated condition. A serious aim of research into alcohol's role in casualties and crime should be to make the world safer for drunkenness. Whether this will result in more drunkenness is an interesting empirical question, but hardly a justification for tolerating continuing deaths and injures. We attempt in this paper to address this potential new strategy. This section analyzes the Consumer Product Safety Commission (an agency whose exclusive role is to promote safety) in detail, discussing (1) its structure, purpose, and history; (2) its view of the role of alcohol in its activities; (3) its attempts to reduce a particular alcohol-related prob- lem residential fires; and (4) possible policy initiatives that can be taken to further the goal of reducing alcohol-related problems. The section titled federal transportation-based jurisdiction discusses similar issues concerning transportation-related safety agencies (except those concerned with automobile traffic). The discussion of the Federal Rail- way Administration includes a section on occupational safety measures, a third type of safety agency responsibility. OSHA (the primary agency prompting occupational safety) and auto safety agencies are not dis- cussed here in the interest of brevity. THE CONSUMER PRODUCT SAFETY COMMISSION (CPSC) Authority The Consumer Product Safety Commission's purpose is to protect the public against unreasonable risk of injury associated with consumer products; to assist consumers in evaluating the comparative safety of consumer products; to develop uniform safety standards for consumer products and to minimize conflicting state and local regulations; and to promote research and investigation into the causes and prevention of

414 POSHER and MOT product-related deaths, illnesses, and injuries. It is empowered to reg- ulate manufacturers, distributors, retailers, private labelers, importers, and other distributors of consumer goods. It may set safety standards, ban hazardous products, require bookkeeping, examine records, call for reports, inspect business premises, impose labeling and warning re- quirements, and demand safety certification. Enforcement is affected by court injunctions, seizure of hazardous products, criminal sanctions, and civil penalties. The CPSC was first established in 1973 by passage of the Consumer Product Safety Act. The legislation was originally proposed in 1970 by the National Commission on Product Safety, which concluded that "the exposures of consumers to unreasonable consumer products is excessive by any standard of measurement" (cited in Green and Moulton 1978, p. 698~. It reported that the costs of accidents involving consumer prod- ucts each year amounted to 20 million injuries (of which 110,000 caused permanent disabilities and 30,000 caused mortalities) and $5.5 billion in financial losses (Comptroller General of the U.S. 1977~. The Consumer Product Safety Act gave the commission additional powers by transferring to it authority over four other statutes the Flam- mable Fabrics Act, the Federal Hazardous Substances Act, the Poison Prevention Packaging Act, and the Refrigerator Safety Act. The Con- sumer Product Safety Act exempts various products from its coverage- most notably, tobacco products, motor vehicles, pesticides, firearms, boats, food, and electronic and medical products although some of them do fall under the commission's jurisdiction by means of one of the other acts (tobacco products are a notable example). Originally, in fact, the Consumer Product Safety Act provided that the transferred acts (which generally granted broader power to the commission than the Consumer Product Safety Act) had precedence if they could alleviate the risk of a particular injury. Each act provides limits on the type of action the CPSC can take. Under the Consumer Product Safety Act, the commission has authority to set consumer product safety standards (following a complex proce- dure, discussed below) and to compel repair, replacement, or refund of purchase price. However, the major enforcement provision relies on notification by manufacturers and distributors, a requirement that is loosely construed. The other acts give the commission authority to re- quire labeling or banning of hazardous substances, to develop special packaging standards for certain household substances so as to protect children, and to issue cease and desist orders against those transporting any product that creates an unreasonable risk of harm.

The Role of Nonalcohol Agencies .. 415 Organization and Procedures The CPSC is an independent agency headed by five commissioners appointed by the president who serve staggered 7-year terms. The pres- ident also appoints the chairman with the consent of Congress, and the chairman retains all administrative and executive powers- to make ap- pointments, allocate work among the staff, and allocate funding. The commissioner's authority is subject to the general policies of the com- mission, although the full commission must approve five major executive appointments. Until recently, these executives reported directly to the chairman once the appointments were approved. There are three advisory councils: the Product Safety Advisory Coun- cil, the National Advisory Committee for the Flammable Fabric Act, and the Poison Prevention Packaging Technical Advisory Committee. Consultation with the second two councils is compulsory, while con- sultation with the first is advisory. The composition of the committees is equally representative of business and consumer interests, with some government representation. Under earlier chairmen, the advisory boards were seldom consulted despite their statutory mandate and ex- erted little influence over commission policy. Under the Consumer Product Safety Act, the commission has the power to set mandatory consumer product safety standards or to enforce voluntary standards by following a complex "offeror" procedure. First, the commission must announce in the Federal Register the need for a new product standard together with all relevant information it has on the product. It must solicit standards from the public and entertain all responses that conform to general guidelines for responding. An existing voluntary standard may be submitted, provided it includes the proce- dures by which the standards were set and the organizations that par- ticipated in its development and approval. The commission may accept an existing standard, pay offerors to develop a new standard, or develop its own standards independently. Usually, outside consultants are hired when this third course is chosen. This procedure is designed to encourage industry to establish its own safety standards and contrasts sharply with procedures followed under the other four acts. For example, under the Hazardous Substances Act, the formal rule-making procedure is started by publishing a proposed regulation in the Federal Register. After considering comments, the commission must act on its proposal. Objections and requests for public hearings must be made within 30 days of the commission's action. Major conflicts often occur over whether performance or design stand- ards should be adopted. Performance standards, favored by industry,

416 MOSHER and MOTTL provide the level of safety that is required without specifying particular design requirements. Thus, variations in design are permitted. Design standards, favored by consumer groups, set specific design specifica- tions. Judicial review of commission standards is much stricter than for other regulatory agencies. If a CPSC ruling is challenged, the court will affirm the commission's power only if it determines that the commission's findings are supported by substantial evidence. Other agencies need only show that their actions are neither `'capricious'' nor "arbitrary." Problems Besetting the Consumer Product Safety Commission The commission has been ineffectual from its inception for a variety of reasons. First, the five acts that comprise its jurisdiction are overlapping and contradictory. The CPSC might decide to proceed under one act only to find in court that it should have followed another act's proce- dures. Second, most actions fall under the Consumer Product Safety Act, which has extremely cumbersome procedures for-setting standards, which cause protracted delays. According to the General Accounting Office, as of mid-1978 only three independent standards had been set- architectural glass, safety matchbook covers, and swimming pool slides and the latter two were later struck down by courts (Comptroller General of the U.S. 1977~. It took an average of 834 days to set these three standards. The delays are violations of the act, which permits only 330 days for completing standard setting. Third, as the two court re- versals indicate, the strict standard for court review puts a severe burden on the commission to justify any action that it takes. This puts the commission on the defensive. as it is easily subject to reversals of its . . c .eclslons. Finally presidential appointments have seriously hampered the com- mission's effectiveness. Richard Simpson, the first chairman (a Nixon appointee) opposed the concept of an independent product safety com- mission and testified against its creation in Congress. Simpson never appointed an executive director during his 2~/~ years and failed to set any objectives or goals. Because of the extraordinary powers of the chairman, his decisions made it impossible for the commission to fulfill its purposes. The appointment of John Byington as Simpson's successor (by President Ford) created new problems. According to U.S. Civil Service Commission (reported in U.S. Congress 1978), Byington ap- pointed an inordinate number of high-level administrators; he was also charged with favoritism and misuse of consultants. In 1978, the De- partment of Justice disclosed that it had found evidence that Byington

The Role of Nonalcohol Agencies 417 had accepted kickbacks, and he resigned soon after (reported in Green and Moulton 1978~. A GAO study in 1977 summed up the commission's problems. It found that the commission suffered from inefficient management' mis- placed priorities' lack of enforcement, lack of adequate data collection? Offeror process delays, and failure to promulgate standards (see Comp- troller General of the U.S. 1978b). Recent Reforms According to the GAO (Comptroller General of the U.S. 1977' 1978b) and a recent article (Green and Moulton 1978), numerous reforms have been recently instituted to help solve many of the commission's prob- lems. All five acts are now equally applicable to products falling under any of their jurisdiction, with minor qualifications. The offeror process has been modified to permit the commission discretion to develop its own standards without following offeror procedures, provided that pub- lic participation is ensured. According to numerous groups contacted during the course of this study, these reforms have improved its performance, although it is still too early to evaluate the commission's effectiveness. Despite recom- mendations by the Office of Management and Budget (OMB) and some members of Congress to abolish the CPSC, it has been refunded until 1981. The Commission and Alcohol-Related Problems One of the purposes of the commission is to investigate the causes and prevention of product-related injuries. One would expect, given this statutory mandate, that the commission would take at least some interest in the role of alcohol consumption in product injuries. Anecdotal in- formation, at least, indicates that the chances of injury are multiplied when alcohol has been consumed. The CPSC, despite its mandate' has in fact ignored alcohol involve- ment in all but one of its investigations. When we contacted the agency and inquired about alcohol information, we were told that we had con- tacted the wrong government agency. When pressed, commission staff told us that accident reports could be examined individually, but there were no compilations of alcohol involvement except in the area of res- idential fires. Upon reviewing the accident reports, we discovered that alcohol information was not standardized' so that alcohol involvement was reported only when the reporter volunteered the information.

418 MOSHER and MOTTE According to CPSC staff, our discoveries conformed to the commis- sion's traditional mode of investigation. It focuses on technological and engineering inadequacies of the products involved without a view toward potential misuse. Its regulations and findings are based on injury sta- tistics associated with particular products. The physical condition of consumers who are injured is generally ignored. The GAO has recently criticized the CPSC for its inadequate data collection, particularly its failure to investigate and report the human factors involved in product injuries (Comptroller General of the U.S. 1977, p. 21~: The Commission's collection and analysis of product-related injury data have been directed toward the mechanical factors associated with such injuries.... However, it has directed little attention toward determining how human fac- tors the way people use products are involved in product-related injuries. Without adequate product exposure data . . . and data on how people actually use products, it is difficult for the Commission to identify adequately the un- reasonable risk of injury. The GAO concludes (p. 254: The Commission's product injury data base, including its surveillance and in- depth investigation activities, does not adequately support its hazard identifi- cation and hazard analysis needs. The Commission needs injury information that it can use to determine the causes of a product-related injury, the product's involvement in the incident, and the user's (people) involvement in the incident. Recently, in a partial reversal of this investigative procedure, the CPSC has created an independent Human Factors Division. Originally housed in the Office of the Medical Director, this division of seven analysts is assigned to research the use of a particular product rather than the product itself. For example, it has conducted a study of skate- boards and has recommended design modifications based on expected use and misuse by young children. Although the product can be con- sidered safe if properly used, the human factor of potential misuse became the basis for a recommendation of reform. The staff reports that if alcohol were to be a consideration in CPSC actions, the Human Factors Division would be the place for involvement. Residential Fires One area in which the CPSC has taken action concerns a well-docu- mented alcohol-related problem. Residential fires caused by cigarette or other tobacco product ignition are surprisingly common in the United

The Role of Nonalcohol Agencies 419 States. According the U.S. Fire Administration (Overbey 1979), there were 70,000 smoking-related fires in 1978 that caused 1,800 deaths, 4,000 injuries, and $180 million in economic losses. These fires constitute approximately 11 percent of all residential fires, 32 percent of residential fatalities, 21 percent of injuries, and 9 percent of dollar losses. A study in Maryland from 1972 to 1977 supports these figures (Bert and Halpin 1978~. There were 295 fatal fires that caused 414 fatalities during the study period. Of the fires ignited by smoking materials, 135 (45.8 per- cent) resulted in 184 (44.4 percent) fatalities. Residential fires are the primary source of fire fatalities in the United States, and tobacco-related fires have contributed substantially to the U.S. per-capita rate of fire deaths, one of the highest in the world. Surveys show a clear association between amount of drinking and amount of smoking (Cahalan et al. 1969, p. 148), and that association carries over to smoking-related fires. In an analysis by the CPSC (1978, pp. 27-29) of 102 fire fatalities in Maryland caused by upholstery fur- niture fires between 1971 and 1977, all but 6 were known to have been ignited by smoking materials (the ignition sources for the others were unknown). Autopsies of 48 of the 102 victims showed alcohol in the blood. Of these victims 32 were under age 15, none of whom showed evidence of alcohol. Thus, among adults, nearly 70 piercers of the fa- talities involved alcohol (see also U.S. Department of Health, Educa- tion, and Welfare 1972, pp. 25-48~. Bert and Halpin (1978), in a separate report of all Maryland fires between 1972 and 1977 (not limited to upholstery-related fires, which represent approximately 25 percent of all fire fatalities during this pe- riod), found a similar correlation of tobacco use, alcohol use, and age. As indicated earlier, smoking materials were the ignition source in 44.4 percent of all Maryland fire fatalities between 1972 and 1977. Thirty- five percent of the victims had a blood alcohol content (BAC) of 0.10 or greater; for the victims between ages 30 and 59, 67 percent had a BAC of 0.10 or greater and 41 percent had a BAC of 0.20 or greater. Alcohol may be involved at various stages of a fire accident. It may create drowsiness, thus causing loss of awareness of a burning cigarette, or it may impair detection of a fire and possible escape. The statistics suggest that such ancillary effects are present. Although smoking-related fires cause only 11 percent of all residential fires, they cause 32 percent of all fatalities, an indication that these fires are likely to go undetected until escape is impossible. The commission has identified residential fires as an unacceptable risk requiring government intervention. The statistics indicate that there are at least five possible factors to be considered: (1) the act of smoking;

420 MOSHER and MOTTL (2) the act of drinking; (3) the structure of the residence itself; (4) the ignition source (tobacco products); and (5) the combustible furniture. In accordance with its emphasis on product design, the commission has not considered the first two factors for possible initiatives (although it has compiled statistics on their involvement). Building designs are also considered outside its jurisdiction. However, its handling of the last two factors provides insights into the commission's political weaknesses. Cigarette papers in American cigarettes are treated with a citrate compound or phosphate salts to ensure longer burning up to 45 minutes after a cigarette is put down on a flat surface. Nitrate compounds in the tobacco itself also heighten this effect. Research has shown that up- holstered furniture and mattresses will not ignite if a cigarette goes out within 5 minutes. Thus many fire experts and most of the major fire protection lobbying groups are advocating a strategy that would require tobacco companies to develop a cigarette that extinguishes if not smoked within a short period of time. The industry opposes this idea on the basis that no method of creating such a cigarette would be acceptable to consumers. Critics charge that the industry is ignoring almost 30 separate patents, has refused to pro- vide researchers with necessary information concerning cigarette ingre- dients, and has failed to conduct any research itself on the feasibility of self-extinguishing designs. Some critics also accuse the industry of op- posing reforms to maximize profits more cigarettes will be sold if they burn when not smoked (and are therefore not available for relighting). i2 The CPSC, during its first years of existence, studied this strategy as well as the strategy of requiring fireproof upholstered furniture and mattresses. However, in 1976, it requested that Congress remove to- bacco products from its jurisdiction. (The commission was being sued at the time by consumer groups to ban nonextinguishing cigarettes.) We were unable to determine the role of the tobacco industry in effecting this change, either at the CPSC or in Congress, but it can be assumed i' Groups supporting this strategy include: the American Burn Association; the Fire Mar- shalls Association of North America; the United States Fire Administration; the Inter- national Association of Fire Chiefs; the National Fire Protection Association; Action on Smoking and Health; and the International Association of Fire Fighters (see Congressional Record, October 16, 1979, p. E5061~. ]2 See, e.g., comments by Gordon Damant, chief of California's Bureau of Home Fur- nishings, CI3S Radio News Special (1979), O'Malley (1979~. '3 there was some conflict concerning the sequence of events prior to this legislative enactment. According to Alan Schoen, in the CPSC's General Council's office, authority over cigarette design was terminated because the commission was never intended to have such jurisdiction. A District of Columbia Federal District Court had ruled otherwise prior

The Role of Nonalcohol Agencies 421 that extensive lobbying was involved.~3 There was no input or protest made by any organization specifically concerned with alcohol-related problems. The upholstery and bedding industries have tried repeatedly to reverse this decision and to fend off what they consider oppressive and ill-advised regulations of their products. A recent popular article details the dif- ficulties contenting the CPSC in reducing fire danger through an up- holstery strategy (O'Malley 1979~. In fact, a CPSC staff member claims that Congress severely hampered its efforts because of these difficulties (O'Malley 1979, p. 60~. Aside from the practical concerns, it is probable that new standards for home furnishings will have little immediate effect. Although statistics are not available, it is likely that smoking-related home fires mainly involve used furnishings and that persons most in danger do not have the financial resources or inclination to invest in new, safer products. The drive for self-extir~guishing cigarettes has continued, despite CPSC inaction. Representative Joe Moakley of Massachusetts and Sen- ator Alan Cranston of California have recently introduced bills into Congress that would require that all cigarette manufacturers have their products extinguish within 5 minutes if not smoked. The Cranston bill would return the responsibility for developing necessary regulations to the CPSC. In Los Angeles, a lawsuit has been filed against a tobacco company for injuries caused by a cigarette-upholstery fire on the theory that the industry is acting negligently in its current practices. Recent publicity of the issue has helped heighten public awareness.~4 However, alcohol prevention strategists have not been involved in any of these recent events. Discussion This history illustrates several points: (~) alcohol-related problems may, in some cases, be best prevented by addressing causal factors other than drinking behavior; (2) the CPSC is politically weak and, as a result, its decisions may reflect political forces in addition to safety-based factors; to the 1976 amendment. Schoen stated that the commission therefore supported the law. One review article stated that the CPSA "requested" the change. O'Malley (1979) in- dicated that Congress independently made the change due to tobacco industry pressure, although implying that at least some members of the commission supported the bill. '4The American Burn Council has established a nationwide campaign to publicize this issue. In addition, the media have been active. There has also been media coverage of Senator Cranston's bill (see, e g., CBS Radio News Special 1979. Waas 1980 O'Malley 1979~.

422 MOSHER and MOTTL (3) alcohol policy makers have ignored the CPSC; (4) overburdensome safety regulations may be the result of the CPSC's abandoning a more promising strategy for political reasons. It appears that the commission is currently undergoing administrative reforms and reevaluation, including reviews of data collection methods (Comptroller General of the U.S. 1978b). A heightened awareness of alcohol involvement in product-related accidents could be included in these reforms. Statistical analyses are needed, which will require changes in reporting forms and compilation designs. Although our contacts with the commission were not encouraging, its revamping may provide some avenues for discussion and accommodation. The CPSC's lack of interest in alcohol rests primarily on a narrow view of its proper functions. Its statutory mandate clearly includes re- search and investigation into the cause and prevention of product-related injuries. CPSC has established a complex, nationwide network for col- lecting injury-related data; providing a small number of questions con- cerning alcohol involvement on existing forms could be a valuable source of information. Because the network now exists, additional expenses would be limited to revamping existing forms and processing the data that are collected. Thus, there appears to be a strong argument for reform. As the GAO has indicated, the commission has also ignored the potential risks of negligent use. As a result, the commission may be ignoring important safety-related strategies that would be particularly relevant to alcohol-related injuries. For example, some products may be highly dangerous even if well designed because they are often used by intoxicated or negligent persons. Simple design changes might sub- stantially reduce these risks, but until adequate studies are conducted, there is no way to assess such reforms. The commission has already recognized the need for such a focus in regard to children (e.g., the child-proof medicine cap).is The formation of an independent Human Factors Division may signal the beginning of reform as to potentially negligent adult use. A relatively small amount of additional funding for this division could prove to be a valuable first step toward evaluating a new strategy for reducing alcohol-related prob- lems. There does not appear to be any conflicting problem in doing so other than commission indifference and perhaps a lack of funds. Despite the lack of encouragement from our contacts wth the commission, the 'sIt should be noted that child protection initiatives may have an incidental effect of protecting intoxicated persons. For example, a depressed person considering a drug over- dose might be unable to open a medicine bottle because of intoxication.

The Role of Nonalcohol Agencies 423 recent CPSC administrative actions indicate that attention and encour- agement from the National Institute on Alcoholism and Alcohol Abuse could prove influential in changing CPSC priorities. Finally, alcohol policy makers need to address the problem of alcohol- related residential fire injuries and deaths. As the statistics show, this is appropriate for prevention efforts. As has been discussed, the CPSC has failed to At on a promising strategy that is now being advocated by major fire protection groups, including the U.S. Fire Administration and the International Association of Fire Chiefs and Fire Fighters. Congressional and public support for that strategy appears to be grow- ing. The public airing of this issue by other interested federal agencies, while not guaranteeing immediate results, may help to reverse previous . . c .eclslons. FEDERAL TRANSPORTATION-BASED JURISDICTION INTRODUCTION The federal government has become increasingly involved in the reg- ulation of all forms of transportation. Because most forms of travel involve complex technologies and may cross state lines, federal presence is essential for creating uniform national standards. Federal jurisdiction may now include: employee practices in the transportation industry; equipment specifications and maintenance; passenger and operator prac- tices; and safety requirements. Although the authority may be shared with particular states, federal transportation powers are extensive and may override state regulations, at least when interstate travel is involved. Alcohol-related transportation problems are common to all parts of the industry and are recognized as both important and difficult to ad- dress. The nature of alcohol involvement may vary. For example, alcohol use by operators of transporting vehicles is a problem for all forms of transport. Alcohol use by trespassers and pedestrians poses a particular problem for the railway industry, and passenger drinking is a potential problem for airline companies. The federal jurisdiction for coping with these problems falls into the two categories already discussed. Regu- lations may be adopted affecting the availability of alcohol in particular situations, and safety and environmental measures may be taken to lessen the impact of existing drinking behavior. This section first presents the activities of the National Transportation Safety Board, a safety agency with authority to study all forms of trans- portation safety measures. Many of its activities are relevant to discus- sions found in the preceding section. Detailed discussions of federal

424 MOSHER and MOTTU activities in the rail and air transport industries follow as well as a brief description of the Coast Guard's jurisdiction of waterway transport. In each case, federal powers over alcohol-related problems are addressed. (Automobile, bus, and truck transportation are omitted as they are outside the scope of this paper.) The section concludes with a discussion of possible regulatory actions, particularly in the railway industry. These policy initiatives illustrate both the scope and the type of reforms within existing federal authority that may reduce alcohol-related problems. NATIONAL TRANSPORTATION SAFETY BOARD Jurisdiction The National Transportation Safety Board (NTSB) was created by the National Transportation Act of 1966, which also created the Department of Transportation (DOT). The board functioned as an autonomous agency under the DOT until 1974, when the Independent Safety Board Act established it as an independent agency that reports exclusively to Congress. Prior to 1966, the board was a division of the Civil Aeronautics Board and its activities were confined exclusively to investigations of air accidents. It has had jurisdiction over surface modes of transportation (including pipelines) since 1966, although its emphasis remains on air- related investigations. The board's legislative mandate is to improve transportation safety generally. Its jurisdiction to do so covers the following areas, among others: investigating major transportation accidents; reporting on the facts, circumstances, and causes of such accidents; making specific rec- ommendations to government agencies and industry for promoting transportation safety; conducting special safety studies and investiga- tions; assessing accident investigatory methods and establishing require- ments for reporting accidents to the board; and evaluating the trans- portation safety consciousness of other government agencies. The board has no regulatory power (other than the power to require certain sta- tistical reporting methods). However, its recommendations, usually based on detailed investigations, are often adopted. One board em- ployee stated that 85 percent of its recommendations are acted on and that the board vigorously follows up on its recommendations, publicizing the issues involved. If a party refuses to adopt a specific recommendation of the board, it must give a detailed explanation within 90 days. Despite its wide range of responsibilities, the NTSB is one of the smallest federal agencies and it often relies on other public and private entities for investigatory assistance. The board consists of three mem- bers, appointed by the president, who serve S-year terms. There are

The Role of Nonalcohol Agencies 425 four offices: managing director, general counsel, public affairs, and ad- ministrative law judges. The Office of the Managing Director houses the Bureau of Accident Investigation, the Bureau of Technology, and the Bureau of Plans and Programs; these bureaus perform the basic work of the board. Investigations of air accidents account for a substantial portion (60 percent) of the budget of these bureaus, although air fatalities account for only 3 percent of all transportation fatalities. All airline accidents and all general aviation accidents involving at least one fatality are investigated—approximately 12,000 accidents annually. The Bureau of Technology, through its Human Factors Division, assists in these in- vestigations. The Marine Accident Division investigates only those ma- jor waterway accidents involving at least six deaths, the sinking of a major vessel, or damages exceeding $500,00(}approximately 80 inves- tigations per year. The Railroad Accident Division limits its investiga- tions to those accidents involving passenger trains or property damage exceeding $150,000, approximately 30 per year. (The pipeline and high- way investigatory divisions, which are both small, are not discussed in this paper.) Investigations of Alcohol Involvement The three investigation divisions discussed above have had at least some exposure to alcohol involvement in transportation accidents. Because of the emphasis on air accidents, the reports on aviation safety are more thorough and provide valuable information concerning alcohol use among general aviation pilots involved in accidents. However, as dis- cussed below, the GAO found that its procedures were inadequate (Comptroller General of the U.S. 197Sa). The Human Factors Division of the Bureau of Technology, in conjunction with the Air Investigation Division, made specific recommendations to the FAA concerning im- plied consent regulations for pilots (discussed below). A employee of the Human Factors Division reported that there is no systematic ap- proach to studying alcohol problems or alcohol as a factor in accidents. The awareness of alcohol involvement in rail and marine accidents is even more fragmented. Only three accidents involving alcohol have been investigated—two train accidents and one marine accident. The marine accident involved a collision between a ferryboat and a tanker on the Mississippi River in which 67 people died (National Transpor- tation Safety Board 1979b). The captain of the ferryboat was intoxicated, and his intoxication, in conjunction with his lack of good judgment and failure to heed waterway rules, was found to be the primary cause of

426 MOSHER and MOTTL the accident. Yet none of the NTSB recommendations concerned al- cohol, and there was no discussion of alcohol as a problem in water transportation. The train accidents involved intoxicated engineers, and significant recommendations were made to the Federal Railroad Admin- istration and the railroad company (discussed below) to change regu- lations and rules concerning drinking behavior (National Transportation Safety Board 1974, 1980~. However, the investigations have not prompted any further study of alcohol as a factor in rail accidents. The NTSB has also conducted a study of trespasser casualties on railroads and found intoxication to be a significant factor. Numerous recommen- dations were made concerning improving safety for trespassers. In its 1978 annual report to Congress, the NTSB devoted a special 3-paragraph section to alcohol and safety. After listing its own frag- mented involvement, the board (197S, p. 105) recommended "the De- partment of Transportation should develop and implement a program designed to reduce dramatically the incidence of alcohol-related acci- dents." No other mention of alcohol involvement was made in the re- port; the 1977 report was completely silent on the subject. In sum, the NTSB, although lacking regulatory authority, has exten- sive jurisdiction: to study the causes of transportation accidents; to pro- vide recommendations; to assess the safety accomplishments of other agencies; and to urge congressional action. It has a record of steady success in promoting safety and has conducted numerous detailed in- vestigations and studies. Its statistical data are invaluable to persons working in the safety field. However, although the board recognizes the importance of alcohol involvement, it has not developed a strategy for determining the role of alcohol in transportation accidents or for re- ducing its impact. Adequate statistics are not forthcoming despite the board's powers to compel accurate and extensive reporting from the various federal agencies; investigations and recommendations usually do not address alcohol impairment (with some exceptions in air trans- port); and no concerted effort has been made in any of the transportation areas to study the role of alcohol in accidents despite its explicit authority and responsibility to do so. Its only recommendations concerning further study~ne of its primary roles was for another agency to take action. '6The NTSB 1978 annual report (p. 63) summarized this study. it analyzes 2.679 railroad pedestrian accidents during a 20-month period and provides recommendations for im- proving railroad pedestrian safety. According to the NTSB the Federal Railway Admin- istration responded by acknowledging the need for railroad pedestrian safety and by initiating a program to select candidate areas for safety improvement and to evaluate the costs and benefits of providing restrictive fencing. NTSB personnel stated that intoxication was a common characteristic of these pedestrian in juries.

The Role of Nonalcohol Agencies THE FEDERAL AVIATION ADMINISTRATION Jurisdiction 427 The Federal Aviation Administration (FAA) has primary jurisdiction over the use of the airways within the United States. Although its ju- risdiction maybe shared in particular instances with various state agen- cies, its overall authority is more comprehensive. Air commerce is de- fined in the Federal Aviation Act to include: "interstate, overseas, or foreign air commerce or the transportation of mail by aircraft or any operation or navigation of aircraft within the limits of any Federal airway or any operation or navigation of aircraft which directly affects, or which may endanger safety in interstate, overseas or foreign air commerce." This definition gives the FAA potential jurisdiction over virtually any flight within the United States. It has been found to include: the cer- tification of pilots, both commercial and private; the behavior of crew members and passengers while in flight; and the design of airplanes and airports. The use of alcoholic beverages may become involved in any of these aspects of FAA jurisdiction. Alcohol Problems in Air Transportation The dangers of using alcoholic beverages while operating an aircraft are well documented (Comptroller General of the U.S. 1978a, Aarens et al. 1977, NTSB 1979a). The physiological effects of alcohol are mag- nified when flying the effects are twice as great at 10,000 feet and three times as great at 15,000 feet as they are at sea level. Since the operation of aircraft is more demanding and complex than the operation of an automobile, it is reasonable to assume that even stricter rules than those applying to driving under the influence of alcohol are needed for reg- ulating pilot behavior. A recent GAO report (Comptroller General of the U.S. 1978a) sub- stantiates this assumption. The report cites a National Transportation Safety Board study, which found that 430 fatal accidents, or 10 percent of all fatal accidents during the 11-year period of 1965-1975, involved alcohol impairment of pilot judgment and efficiency. The GAO report argued that this figure was underestimated because of an unrealistically high BAC requirement before alcohol impairment was assumed. It cites tests conducted by the FAA's Civil Aeromedical Institute indicating that 818, or approximately 20 percent of fatal aviation accidents during that period, involved alcohol impairment. This figure may still be underes- timated because of FAA's failure to obtain adequate BAC testing. The

428 MOSHER and MOTTL GAO also found that, in one sample of 163 accidents involving pilot impairment, 63 percent involved alcohol. (For a summary of various studies that support these findings see Aarens et al. 1977, pp. 76-80~. Aviation accidents involving alcohol impairment are concentrated almost exclusively in private or general aviation flights. Commercial airlines have an excellent record of maintaining sobriety among their pilots before and during flights. Drinking by passengers on commercial airlines is a second alcohol- related problem area in which the FAA plays a major role. Although figures are unavailable, it can be assumed that there is a high volume of consumption.~7 Drinking has become one of the main activities of passengers flying commercially, and air travel has increased dramatically in recent decades. The alcohol beverage industry, recognizing this po- tential market, has many of its advertisements directed at this drinking context. The FAA does not act as the actual dispenser or retailer on airplanes; however, it does have regulatory authority similar to state ABC boards; the airline companies have the role of retailer. Until 1972, the airlines imposed a voluntary two-drink maximum; since then no maximum has been enforced. Free drinks and *ee refills are often used to promote carrier popularity and first-class patronage. The FAA and its predeces- sor, the Civil Aeronautics Board (CAB), have taken no action con- cerning drink limits or the dispensing of free drinks. An association of flight attendants has made two requests for a one-drink maximum per 1~/: hours of flight, to which the FAA has not responded. In addition to increasing the health dangers that are associated with increased consumption generally, drinking during commercial flights may contribute to auto accidents by passengers who drive from airports after arrival. Although there has been no study of this potential danger, a recent program of the California ABC strongly suggests that driving from an airport while intoxicated is a common occurrence.~9 Recent publicity concerning assaults on commercial flights points to another danger of in-flight alcohol service. According to the Association t7 The FAA does not collect data concerning how much alcohol is sold during commercial flights. The information is apparently only available from airline companies on an indi- vidual basis. (This conclusion is based on conversations with FAA personnel and with William Jankman of the American Airlines Transportation Association.) '8 this information was obtained from Del Fina, Association of Flight Attendants. '9 See Mosher and Wallack (1979) for a discussion of this project. The project, in part, recorded information from drunk driver arrest reports in Los Angeles County, which included a question concerning where the driver had been drinking The Los Angeles International Airport was among the top five locations recorded.

The Role of Nonalcohol Agencies 429 of Flight Attendants, there were 60 assaults on its members in 1978, up from a figure of 25 in 1975.2° About half of the assaults involved drunken passengers. Attendants complain that airline companies do not screen passengers to keep intoxicated persons off planes and have failed to support attendants who refuse to serve intoxicated passengers. In some instances, they charge, the airlines have instead taken disciplinary action against the attendants. There is apparently a tension between company policies, which see attendants as primarily food and drink servers, and union policies, which see its members' role as one of ensuring passenger safety. The FAA has shown little interest in the assault problem. FAA Regulations and Response The FAA has promulgated the following regulations in an attempt to cope with alcohol-related problems: (1) no commercial airline may serve any alcoholic beverages to any person in the aircraft who appears intoxicated, who is carrying a deadly weapon, or who Is in criminal custody; (2) no commercial airline may permit a person who appears to be intoxicated to board an aircraft; (3) no passenger on a commercial airline may carry on board any alcoholic beverage; (4) no person may act as pilot or crew member (commercial or pri- vate) within ~ hours after the consumption of any alcohol or while under the influence of alcohol (the "8-hour ruled; (5) no private aircraft may carry any person who is "obviously under the influence of intoxicating liquors." In addition, the FAA determines the qualifications for receiving a pilot's license. A medical certificate is necessary, and the regulations provide that an applicant will be disqualified if he or she has an estab- lished medical history of alcoholism. Alcoholism is defined as a "con- dition in which a person's intake of alcohol is great enough to damage his physical health or personal or social functioning, or when alcohol has become a prerequisite to his normal functioning." The FAA's Office of Aviation Medicine, in a memo dated November 20 These statistics were obtained from Del Fina of the Association of Flight Attendants. An FAA spokesman reported 75 violations of laws prohibiting interference with crew members in 1978 (Frank 1979~. The Association of Flight Attendants has hired a law firm to prosecute private suits, on behalf of attendants who have been assaulted, against the passengers involved.

430 MOSHER and MOTTE 10, 1976, described the procedures for enforcing the alcoholism regu- lation (FAA 1976~. The memo first notes the difficulty in defining "al- coholic" and differentiating "alcoholism," "incipient alcoholism," and "alcohol abuse." However, it points to certain objective criteria that should be seriously considered.- These include: (1) a history of more than one arrest for driving an automobile while intoxicated; (2) the need for medical detoxification; (3) the development of neuropathy; (4) al- coholic psychoses, including delirium tremens; or (5) seizures in with- drawal. Recently, the FAA, in conjunction with NIAAA, has conducted a reinstatement program for those who successfully complete treatment. Finally, the FAA has conducted voluntary education programs con- cerning alcohol and flying (Comptroller General of the U.S. 1978a, pp. 20-23~. These include distribution of literature concerning the dangers of alcohol to pilots and presentations during the general aviation accident prevention programs. The contents of these programs are left largely up to the individual coordinators, and the inclusion of alcohol varies from region to region. Alcohol is also a suggested topic for the biennial flight review program (a program to test pilots' awareness of current general operating and flight rules, and includes a flight test). Again, the inclusion of alcohol information varies from region to region. According to the GAO, these regulations are inadequate in numerous respects. It argues that the 8-hour rule is inadequate because a pilot can still be under the influence after abstaining for that time. In fact, many commercial airlines require a 24-hour abstinence period, and the FAA's own handbook for pilots suggests a 12-hour period. The regulations also offer no guidance in defining "under the influence." The FAA has failed to set mandatory minimum alcohol levels and implied consent regula- tions, despite specific NTSB recommendations to do so. The GAO argues that such provisions would help the FAA identify alcohol's role in accidents, improve enforcement, reduce investigatory time, and serve as a deterrent to pilots considering drinking before or during flight. The GAO also criticized the review procedures for issuing medical certificates. Its investigation showed that many of those pilots involved in alcohol-related flying accidents had received state convictions for alcohol-related traffic violations (9 of 35 in 19754. Furthermore, the GAO estimated that as many as 12,000 licensed pilots have had their driver's licenses revoked for driving while intoxicated without FAA knowledge. Applicants for FAA medical certificates who have past al- cohol-related convictions were found to routinely omit their criminal records, and the FAA has taken no precautions to check the applica- tions, although the means to do so are available. The GAO also roundly criticized the FAA educational programs.

The Role of Nonalcohol Agencies 431 According to GAO, alcohol is Reemphasized by many program coor- dinators, and there was no effort on the FAA's part to ensure that educational materials were universally distributed. According to agency personnel, the FAA, in response to the GAO recommendations and criticisms, have taken the following actions: (1) updated seminars (every 5 years) for medical examiners, which include material on alcohol-related problems; (2) searched for laboratory re- ports that might help in the detection of alcoholism and chronic alcohol- related problems; (3) undertaken a legal review of regulations. These actions are minimal at best and do not address most of the GAO con- cerns. FEDERAL RAILROAD ADMINISTRATION Recent headlines have accentuated the need for increased railway safety. In November 1979 a Canadian city of over 200,000 persons had to be evacuated due to a derailment of a train carrying chlorine gas. During the same month, similar derailment accidents (in sparsely populated areas) were reported in Florida (involving propane), Michigan (involv- ing ammoniated hydrogen fluoride), and Indiana (involving a variety of toxic gases. As these accidents indicate, the United States is in- creasingly dependent on trains for transporting dangerous chemicals and nuclear waste. Statistics show an alarming increase in the number of accidents in which trains carrying hazardous materials release dangerous chemicals into the atmosphere, forcing evacuation in surrounding areas.22 A single accident can have profound effects, as serious as the 2' These incidents were reported in four separate news articles in the San Francisco Chron- icle: November 6, 1979, p. 6; November 12. 1979. p. 2; November 13, 1979, p. 2 (two articles). ~2 The following table shows the steady increases in accidents and consequences resulting from the operation of trains carrying hazardous materials (from FRA 1976. 1977, 1978): Total accidents (trains carrying hazardous materials) Total railroad cars damaged Total cars releasing hazardous materials Total persons evacuated i975 690 847 131 3,495 1976 - 798 903 166 19.369 977 864 1.()72 173 14 1()5 This represents a 25.2-percent increase in the number of accidents; a 26.6-percent increase in number of railway cars damaged: and a 32.1-percent increase in the number of cars releasing hazardous materials into the environment in a 2-year period. The wide fluctuation in evacuation statistics shows the dependency of such figures on the place of accident. The large increases suggest that the risk of a major accident in a populated area will increase with the number of accidents.

432 MOSHER and MOTTE Three Mile Island incident. Even discounting the potential for a cata- strophic accident, rail travel has proven to create serious dangers to employees, passengers, automobile travelers, and pedestrians. In 1977, the most recent statistics available, there were 76,574 separate train accidents in which 1,530 people were killed and 67,867 were injured. The NTSB states that the rate of accidents, including those involving hazardous materials, is steadily increasing (NTSB 1979a, p. 26, NTSB 1978, p. 324. Jurisdiction The Federal Railroad Administration (FRA), a part of the Department of Transportation, administers and enforces federal laws and regulations designed to promote safety. It has financial and safety jurisdiction over AMTRAK and safety jurisdiction over USRA (Con Rail) and other lines. It does not regulate regional or urban rail systems, except for interstate common carriers who carry commuter traffic. Its jurisdiction over safety includes accident investigations, regulation~of equipment design and use, and regulation of railroad procedures, including hours of service, employee practices, and record inspection. The FRA is also charged with developing program and policy positions for the Depart- ment of Transportation, which includes authority to design appropriate studies, analyses, and evaluations. Despite this wide range of authority and the potential dangers to society, the FRA has taken virtually no regulatory action concerning alcohol-related problems on railroads. Its primary strategy has been to delegate all responsibility to union and management groups, attempting to provide support and encouragement to railroad employee assistance programs. These programs determine whether an employee is in need of treatment for alcohol abuse or alcoholism and, if so, either provide necessary treatment or refer the employee to an appropriate agency. Overregulation is cited as the prime justification for the FRA's hands- off policy. As a result, there are no federal standards for employees' drinking practices on the job or before coming to work and no proce- dures for handling offenders. Industry Rules The railroads themselves do have rules pertaining to employee drinking. Rule G of the General Rules in the Consolidated Code of Operating Rules of the Association of American Railroads (cited in Mannello and Seaman 1979, p. ix) provides that operating personnel shall not possess

The Role of Nonalcohol Agencies 433 or use intoxicants or be intoxicated while on duty or on company prop- erty, and shall not use intoxicants while on call. (Most railroad operating personnel are on call 8 hours after any duty period. Some management personnel are on 24-hour call, which means, technically, that any drink- ing among this group constitutes a rule violation.) Although Rule G does not apply to all railroads (including AMTRAK), most or all rail- roads have similar or identical company policies, at least implicitly, and in most cases, the company rules include exempt and nonoperating personnel (Mannello and Seaman 1979~. The potential consequences for most railroad workers are very severe~dismissal can result after only one offense, provided a lengthy and complicated appeals procedure is followed. Alcohol-Related Problems Within the Railroad Industry—The University Research Corporation Study Until recently, the FRA had failed to conduct any studies concerning the extent and potential costs of alcohol-related problems. In 1979, a report by Mannello and Seaman of the University Research Corporation (URC), which was commissioned by the- FRA and was the result of 3 years of study, provided the first extensive research in this area (ref- erenced as Mannello and Seaman 1979; hereafter referred to as URC 1979~. The drinking practices and problems among employees and their responses to voluntary treatment programs in seven major-railroads were studied in detail, relying primarily on questionnaire and interview data. The sample railroads account for nearly half of all railroad workers and range from very large to relatively small companies. Although the primary purpose of the study was to evaluate employee assistance pro- grams, many of its findings are relevant here. The findings are startling. The report states that 19 percent of those studied, or an estimated 44,000 of 234,000 of the workers for the 7 railroads (23 percent or an estimated 16,000 of 72,000 of all operating personnel), are problem drinkers. In some companies, the rates of op- erating personnel, the most important employees in terms of potential safety hazards, reach over 34 percent. Railroad workers are twice as likely to drink on "binges" as men nationally. An estimated 28,000 workers (12 percent) were drunk on the job at least once in 1978. On- the-job drinking was found to be extensive. Twenty percent, or an estimated 46,000 workers, came to work hung over at least once in 1978, and an estimated 7,000 were too hung over to perform their duties. Another 30,000 employees were drunk while on call. The national av- erage for adult men being intoxicated on the job at least once a year

434 MOSHER and MOTTL is only 1.5 percent, indicating that drinking among railway employees is extremely high compared with other industries. In total, the URC report estimated that there were 174,000 violations of the drinking rules in 1978. Despite the high incidence of drinking on the job, the number of rule violations reported to the companies was remarkably low. There were only 900 disciplinary notices served on employees, and only 383 of these led to official proceedings resulting in dismissal (0.4 percent of all on- duty drinking violations). Interviews with supervisors indicated that both benign neglect and extreme selectiveness were involved. Supervisors are reluctant to report violations because of the severity of the potential punishment and the pervasiveness of the drinking practices. Fifty-five percent of all supervisors stated that they never report a first offender. They also indicated that the personality of the offender could affect the decision. Thus, disciplinary action concerning drinking may well reflect an employee's work difficulties unrelated to drinking problems. Given the extent of drinking and lack of rule enforcement, it is not surprising that the URC study found extensive alcohol-related problems among the seven railroads. It found that injuries and property damage attributable to alcohol were extensive, although the report stressed the lack of adequate data. The financial cost of loss of productivity due to drinking on or before the job was also estimated to be quite high. Questionnaire results show that workers attribute approximately 5 per- cent of all injuries to alcohol involvement. The URC study found that this figure was a substantially underreported one. Moreover, it does not include trespasser injuries, which, according to the NTSB, may involve intoxicated persons. The URC study had to rely on worker questionnaire reports because neither the FRA nor the railroad companies have any procedures for determining the role of alcohol in railway accidents. The URC study found that railroad medical and safety officers make no investigation to determine causes of accidents. Reports are instead generated from the field, where reporting of alcohol involvement is discouraged. Safety officers' estimates of alcohol involvement ranged from 1 percent to 50 percent. One officer stated that accident reports sent to the FRA failed to mention drinking even when it was involved. There are many possible explanations for the industry's failure to report alcohol involvement in accidents. According to the URC report, the railroad companies are concerned that such reports could lead to civil liability to those injured (customers, trespassers, or employees). Evidence that a company permitted or failed to take reasonable steps to prevent heavy drinking by train operators involved in accidents vir-

The Role of Nonalcohol Agencies 435 tually ensures a finding of company negligence in civil lawsuits.23 Alcohol involvement reports would also result in poor public relations and po- tential endangering of federal funds. FRA statistical analyses substantiate the ARC findings and show steadily increasing safety problems (FRA 1977, 1978~. In 1976, there were 1,684 fatalities and 65,387 injuries in 73,510 separate occurrences connected with railroad operation (excluding rapid transit). Although fatalities have dropped during the last 10 years, injuries have become much more frequent. The rate of accidents per 1 million train miles has nearly doubled since 1967, from 7.72 to more than 14 in 1978 (NTSB 197S, p. 26~. FRA divides all untoward occurrences into "accidents" and "inci- dents." Accidents involve those occurrences that result in damage of $1,750 (as of 1976~24 or more; in 1976 they accounted for approximately 14 percent of all occurrences, 7 percent of all fatalities, and 1 percent of all injuries. Incidents accounted for all remaining occurrences and, because they account for most injuries and fatalities, are obviously im- portant for determining human safety standards. Yet analyses of "human factors" and alcohol involvement are limited to accident statistics only. These show that 2,360 of the 10,248 accidents (23 percent) in 1976 were caused by human factors but only 2 of these (a derailment and a collision) were attributed to "impairment of efficiency and judgment due to drugs and alcohol." Neither of these reported alcohol-related accidents caused any injury or fatality. For 1977, the FRA reported that there were no accidents attributed to drug and alcohol impairment. As for "incidents," there are no human factors statistics in the reports. The FRA is obviously attributing alcohol-related accidents to other factors. There is no compilation of blood alcohol levels in accidents and apparently no requirement that potential drinking involvement be re- ported. Yet all parties, including the industry itself, admit that the sta- tistics ignore a basic problem. For example, according to J. C. Kenefick (1977, p. 4), President of Union Pacific Railroad, the railroad industry probably has an alcoholism rate among its employees of over 10 percent and such employees have an accident rate three to four times higher than other employees. 23 Legal negligence doctrines do not necessitate such a result; the primary determination is whether the operator acted reasonably or unreasonably under the particular circum- stances. Evidence of intoxication, however, is often crucial to jury deliberations. It should also be noted that the finding of negligence on the part of an operator does not necessarily result in a finding of liability, since a number of defenses may be applicable (Dooley and Mosher 1978~. 24 This figure was raised to $2,300 in 1977 and $2,900 in 1980.

436 MOSHER and MOTTL Environmental Factors Contributing to Alcohol-Relatedt Problems2s Employment practices in the railroad industry contribute substantially to potential alcohol problems among operating employees. First, most personnel are on call 8 hours after every work shift. Workers who leave work and drink before sleeping (a norm among a large percentage of American workers) will very likely be drowsy and unfit for work ~ hours later. The on-call procedure virtually ensures that drinkers, even those obeying the rules, will be a potential hazard if called to work ~ hours after going off duty. This practice contrasts with airline procedures for commercial pilots, which emphasize extended dry periods before going on duty and longer off-duty periods. Second, sick leave practices probably tend to accentuate drinking problems. Unlike most industries, railroads usually do not provide any sick leave to their employees. Thus, employees with alcohol-related maladies (drunkenness, hangovers, etc.) face a choice of no pay or appearing for work. Finally, train operators are often stationed at away- from-home terminals. These layovers, according to the URC report, have traditionally been occasions for drinking; almost half the employees surveyed felt that at least moderate drinking should not be prohibited. Thus, away-from-home layovers provide a drinking context between shifts and increase the likelihood of intoxication on the job. These employee practices do not necessarily encourage drinking itself; rather they increase the probability that drinking employees will be on the job while under the influence of alcohol. For example, providing a longer rest period before being on call would give drinking employees a chance to sleep off a night's drinking. Sick leave benefits would not reduce an employee's likelihood of drinking (even on the sick day itself) but they would establish an industry policy that incapacitated workers would not lose wages for failing to appear for work. Thus, the emphasis here is on structuring working conditions so that an employee's drinking is less likely to interfere with his or her job performance. UNITED STATES COAST GUARD The Coast Guard's jurisdiction includes all navigable waters in the United States and federal impoundments (lakes, rivers, etc., on federal lands). To an extent, its jurisdiction overlaps that of the Corps of En- gineers, the National Park Service, and the National Forest Service. Its 25 Much of the analysis for this topic is based on conversations with Robin Room, Director, Social Research Group, School of Public Health, University of California, Berkeley.

1 The Role of Nonalcohol Agencies 437 authority over alcohol use includes sales and consumption on board vessels and the operation of clubs on its bases. The Coast Guard's clubs were not investigated for our study. It does have a deglamorization program; however, the study of the operations of the Department of Defense, which are much larger, is adequate for exploring such programs for the purposes of this paper.26 Boating accidents and drownings are a major source of injury and death in the United States. There were almost 8,000 drowning deaths in 1975, most of which concerned persons under 25 years of age (Aarens et al. 1977, pp. 80-86~. In 197S, there were 1,321 fatalities and at least 1,761 injuries (many were not reported) in the United States caused by noncommercial recreational boating accidents and 4,268 commercial casualties (U.S. Coast Guard 1979a,b). Although the data are sparse, available information on boating ac- cidents and drownings suggest that alcohol is a major factor. In one study of statistics collected by the coroner's office in several large cities, over 40 percent of the drowning victims had measurable BAC levels. In a survey of boating-related drownings in Maryland, 79 percent had positive BAC levels and the average level was 0.077. A Coast Guard official stated that a study in North Carolina (a state that maintains an excellent reporting system) showed that almost half of all recreational craft fatalities had significant BAC levels. Other studies cited in Aarens et al. (1977, pp. 80-86) support these results. There are physiological factors concerning alcohol use that are rele- vant here. Alcohol produces a "pseudo-warmth" effect, which may en- courage swimmers to remain in cold water too long, causing overex- posure and subsequent drowning. Boating accidents are frequently caused by poor judgment and lack of coordination, effects that are associated with alcohol use. Alcohol may adversely affect the swallowing and breathing reflexes, decreasing a drowning person's chances of sur- vival. The effects of alcohol may be magnified in boating accidents because of fatigue and the stress of exposure to wind, sun, water, and vibration. A Coast Guard official mentioned one study that found that fatigue and alcohol together produce a "quantum jump" in debilitation. The Coast Guard, through its Office of Boating Safety, regulates the operation of recreational crafts. There are no regulations that are specific regarding alcohol. The Federal Boat Safety Act provides civil penalties for negligence and criminal penalties for gross negligence in the oper- 26These efforts are directed at Coast Guard employees themselves. There is an alcohol and drug program within the Personnel Office, which, among other activities, conducts educational sessions for supervisory personnel.

438 MOSHER and MOTTL ation of boats. These would encompass accidents arising from injurious operation by intoxicated persons but are not specifically designed as measures for reducing the number of persons who are intoxicated while boating. The Coast Guard has taken a policy position that each state is responsible for promulgating laws governing craft operation and that each state has the primary duty of enforcing such laws. In fact, it in- terprets the Federal Boat Safety Act as mandating this position. How- ever, one Coast Guard official stated that he knew of few states that regulate the use of alcohol on recreational boats. An examination of the Federal Boat Safety Act does not support this interpretation; it gives the Coast Guard a clear mandate to~promote safety and the power to promulgate regulations to that end; there are no provisions prohibiting it from enacting alcohol-specific regulations. Its lack of interest may be justified in many areas by its lack of resources. However, the Coast Guard maintains large stations on many major waterways, and its extensive involvement in recreational boat travel would justify more attention to alcohol use. The Coast Guard also has authority to regulate various aspects of commercial resale operations, including vessel design; license qualifi- cations for various personnel; license review when infractions are re- ported; and operation practices. Yet Coast Guard regulations governing commercial vessels lack any alcohol-specific provisions. Licensing re- quirements for pilots, chief engineers, and mates contain no provisions concerning chronic alcohol problems, and there are no specific prohi- bitions against working under the influence of alcohol. Licensing pro- visions require good character, habits, etc. A search is made for criminal records, particularly for violent crimes and narcotics convictions, but prior history of alcoholism or heavy drinking is not probed for. Overall, it appears that alcohol problems are ignored in determining the fitness of those in charge of safe and efficient ship operation. There are also no specific regulations prohibiting drinking or being under the influence of alcohol while on duty. If the master or chief engineer discovers someone drunk on duty it is within his discretion to "log" him. If logged, the case is reviewed by the Coast Guard. Charges may be brought and a hearing held to consider license revocation. An official of the investigation division stated that such charges are not uncommon; however, the infraction is not technically related to intox- ication but rather is classed as nonperformance of an assigned duty. Thus, collecting data on its frequency is impossible. Ship masters generally allow crew members to bring alcohol aboard for use during a voyage, as many galleys do not provide alcoholic bev- erages of any kind. There is no control or review of this practice, nor

The Role of Nonalcohol Agencies 439 is there any regulation of serving practices on boats that serve alcohol on board. Despite this lack of regulation, the Coast Guard Office of Accident Investigation stated that alcohol is frequently reported as a factor in boating accidents. However, an analysis of its statistics on commercial vessel accidents (U.S. Coast Guard 1979a,b) shows that alcohol involve- ment is not systematically reported and is probably scattered among several categories of potential causes. Furthermore, the figures are con- sidered unreliable because reporting and examination practices vary between localities many fail to perform autopsies or ascertain blood alcohol content except in unusual circumstances or in the case of sus- pected alcohol use. Educational materials, which the Coast Guard publishes and distrib- utes to various groups the Coast Guard Auxiliary, the Boy Scouts, Red Cross, etc. include some warnings of the effects of alcohol use on boating safety. They include such suggestions as not to raise "cocktail flags" until boating is over. However, there are no efforts to have these materials distributed generally to boat owners and operators. The Coast Guard has also been involved in setting requirements for boat design. The Coast Guard in 1975 commissioned a study of alcohol and boating safety that pointed to the need for development of standards for alcohol use during boating operation (Stiehl 1975~. It gave several recommen- dations for conducting necessary research for this purpose, although the Coast Guard has apparently taken no steps to accomplish this. DISCUSSION There appears to be a heavy emphasis on safety and a general recognition of alcohol involvement in transportation accidents among most of the federal agencies we studied. It is therefore surprising that there has been so little effort to evaluate the scope of the problem or to plan and implement programs to contend with it. Part of this failure may be due to unnecessarily limited views of the agencies' authority and duty. The FAA has neglected to institute restrictions on availability for airline passengers, apparently because it does not feel the issue warrants at- tention. The FRA believes that the availability of alcohol on the job is purely a matter for the industry, a position that contrasts sharply with FAA regulations. The main strategies involve encouraging and imple- menting rehabilitation and treatment programs, which are the general federal approaches to alcohol-related problems. As previously discussed' this view, while a necessary component of

440 MOSHER and MOTTE an overall strategy, is limited and ignores important policy possibilities. Alcohol policy makers need to tap the resources of transportation in- dustries and stimulate new directions for reducing alcohol-related prob- lems. While a full analysis of the possible initiatives is beyond the scope of this study, some specific first steps can be outlined. No recommen- dations concerning Coast Guard activities are given, although reforms in statistical methods are obviously relevant. National Transportation Safety Board The NTSB has full authority and responsibility to conduct studies of alcohol involvement in transportation accidents and to require adequate statistics from the regulatory agencies involved. It has numerous ongoing studies and has already taken a position that there is a need for a detailed study of alcohol involvement in transportation accidents. Thus, the board may be an excellent agency to approach for just such a study. We were unable to determine the likelihood of success of such a request, but board personnel appeared receptive. Budgetary problems appear to be a hindrance to ready acceptance, but board publications make clear that an alcohol study would be an appropriate endeavor. In conjunction with such a study, a thorough revamping of the meth- ods of reporting alcohol involvement would be beneficial. This is par- ticularly true with regard to railroad accidents, as the FRA appears very reluctant to take any action on its own. The NTSB has full authority to require adequate reporting, and NIAAA could provide both encour- agement and advice. It should be noted that the NTSB, while lacking regulatory authority (except that it can require particular reporting tech- niques), is a respected agency capable of generating public and congres- sional support for its recommendations. Federal Aviation Administration Many of the FAA reforms recommended by the GAO report appear to have merit. Without addressing these broader issues, two specific issues can still be considered. First, a possible drink maximum on com- mercial flights either an absolute maximum or a sliding maximum de- pending on hours in flight—could provide an excellent means for ad- dressing alcohol-related problems on both a symbolic and a practical level. The use of free drinks for promotional purposes should also be examined. There can be few policy objectives served by continuing the FAA's hands-off approach to the availability of alcohol other than pro- viding a small additional income to the airline industry. Counterbal-

The Role of Nonalcoho! Agencies 441 ancing this concern are the possible health and safety problems asso- ciated with passenger drinking. Furthermore, the current FAA policy in effect encourages excessive drinking, and reform could have signifi- cant symbolic value for highlighting NIAAA's concerns. The FAA's policies concerning tobacco products demonstrate the feasibility and potential value of a maximum-drink initiative. Although our contacts with the FAA were not encouraging, efforts to seek reform could still be attempted. Potential supporters include flight attendant associations and some members of Congress.27 Second, the lack of implied consent provisions for private pilots similar to those used for drunk drivers should be addressed. The NTSB and GAO have both urged FAA action, and, in fact, the FAA has agreed to act. Many states have their own provisions, but they are ineffective for air traffic without a national policy. This is an important issue for alcohol policy makers, at least on the level of providing more accurate data on alcohol involvement. Federal Railroad Administration Recommendations for FRA action are more problematical. Despite the evidence of alcohol impairment among train operators and the dangers it creates to the American public, the FRA, which is charged with the duty to promote safety within the railroad industry, has provided vir- tually no leadership to reduce alcohol-related accidents and injuries. A 1974 NTSB report is illustrative. The report (National Transportation Safety Board 1974) concerns a 1973 collision of two trains, which caused over $1 million in damage and two fatalities. It concluded (p. 16) that the accident was caused by "the failure of the crew [of one of the trains] to stop their train, which was being operated at excessive speed by an engineer under the influence of alcohol [0.16 percent blood alcohol level]." The NTSB made numerous recommendations, which included: prohibiting use of alcohol for a specified period prior to reporting for duty; establishing procedures for conductors to examine crew members coming on duty; determining what environmental conditions contribute to crew members falling asleep at the controls; developing equipment modifications so that a train will stop if the engineer falls asleep; and 27 There is some support for FAA action concerning availability of alcohol on commercial flights. The Globe (January 1979, page 22) reports that Congressman Charles E. Bennet has introduced a bill to end free drinks on the airlines and that Congressman Harold E. Johnson, Chairman of the House Committee on Public Works and Transportation, has ordered a study into the matter. The Christian Science Monitor carried an editorial entitled "Keep Liquor Out of Planes" in a September 1978 issue.

442 MOSH E R an d MOTTL providing better training to new employees (pp. 16-17). The FRA acted on none of these recommendations, finding them either unfeasible or not "cost-efficient." Its response to the alcohol- involvement problem has been to encourage railroad companies to in- stitute voluntary treatment programs. In April 1975, Asaph H. Hall, administrator of FRA, stated (1975, pp. 4-5~: Last year the National Transportation Safety Board recommended to FRA . . . that safety regulations covering use of alcohol and drugs be issued. We looked into the matter and came up with a draft of a proposed rulemaking.... The draft proposal was put before the new Railroad Operating Rules Advisory Committee for comment. The response from both labor and management was nearly unanimous federal regulations are not necessary; management and la- bor can handle the situation satisfactorily among themselves. My own review of the situation bears out this statement. It does appear that the rail industry is moving positively to solve the problem without adding further outside government pressure. The last thing we want to do is to rush into federal regulation when it is not required. In 1979, after much industry activity to implement and expand em- ployee assistance programs, a serious accident involving two deaths and over $1 million in damages occurred. The NTSB determined that the engineer was intoxicated at the time of the accident and that his intox- ication was a "significant causal factor" of the accident (National Trans- portation Safety Board 1980, p. 10~. The NTSB repeated its 1973 rec- ommendations and noted that while it "approves and supports" the rehabilitation programs, they do "not prevent employees from working while impaired by alcohol" (National Transportation Safety Board 1980, p. 11~. Significantly, the only reports of alcohol^related accidents in- volving railroads that we could obtain came from the NTSB rather than the FRA. Unfortunately, the FRA's lack of leadership does not appear to be limited to this one area. The NTSB reports (1979a, p. 95~: During 1977 and 1978, it became apparent that the Federal rail safety programs and regulations had not achieved the degree of safety required by the public and Congress. The Congressional Office of Technology Assessment in its major evaluation of railroad safety issued May 1978, indicated a number of findings: Train derailments and total accidents are continually increasing in spite of Fed- eral regulations and enforcement efforts; accident data have not been adequately used in the determination of priority objectives to address improvements in rail safety; and alternative approaches to the regulatory process have not been considered.

1 The Role of Nonalcohol Agencies 443 Most disturbing is the FRA's failure to implement adequate safety measures concerning the transport of hazardous materials. The NTSB, in its 1978 annual report, states (p. 57~: FRA activities have not resulted in significant improvements in the safety of rail transportation of hazardous materials. The Board found that . . . organi- zational structure and program arrangements and procedures have impeded safety effectiveness. Recent accidents indicate that the hazards are at least as great today in spite of repeated NTSB pressure for FRA action. Despite the FRA's reluctance to take safety initiatives, the widespread use of alcohol among railroad employees, the present rate of deaths and injuries associated with rail travel, and the profound dangers posed by rail transport of hazardous materials all point to the need for policy reform. The reforms discussed below need exploration by those con- cerned with reducing alcohol-related problems. Statistical Analyses The FRA, as indicated earlier, has made no effort to ascertain the role of alcohol in railroad accidents. In fact, its methods make it virtually impossible to determine the role of human error gen- erally. Human factors statistics do not even include train "incidents," which account for most injuries and fatalities. Instead, they analyze "accidents" only, and the distinguishing factor between accidents and incidents is a monetary figure. This illustrates the FRA's failure to emphasize human safety concerns. Obtaining accurate statistics is es- sential and is relevant to other recommendations. They may also lead to additional policy initiatives. Both the NTSB and the FRA could provide accurate and simple methods for reporting accidents so that alcohol information is recorded. As indicated earlier, there are difficulties beyond statistical meth- odology for obtaining accurate alcohol information. The railroad in- dustry has primary responsibility for reporting accidents, and they are reluctant to include alcohol as a causal factor for a variety of reasons. Thus, there may be a need to include at least some outside, governmental supervision of reporting techniques to ensure that statistics are accurate and complete. Sampling techniques of different classes of accidents could be used to avoid the necessity of maintaining a large network of accident investigators. The FAA and the NTSB experiences in reporting alcohol involvement in aviation accidents could provide some guidance in this area. Regulation of Employee Drinking There are numerous problems with

444 MOSHER and MOTTL current alcohol rules affecting employee drinking practices. First, in- dustry rules prohibit employees from being intoxicated on duty, but they do not provide a "dry" period prior to reporting for duty. Thus, even a rule-abiding engineer could be intoxicated on the job. The FAA's 8- hour rule for private pilots (and the airline industry's 24-hour rule for its crew members) is illustrative of an alternative for dealing with this problem. Second, current on-the-job rules deter detection and provide unwar- ranted punishments for violations. The URC report shows that em- ployees are likely to cover up a coworker's drunkenness for fear of causing a dismissal even if the failure to report endangers lives. Super- visors are unlikely to report violations unless the violator is generally unproductive or disliked. These practices cause discrimination, impair referrals to treatment programs, and increase the likelihood of drunken workers on the job. A number of alternatives could help alleviate this situation. For ex- ample, the NTSB has recommended that conductors be required to check all train employees to ensure they are physically capable of per- forming their duties. In addition, the URC has recommended that pun- ishment for violations (which, technically, calls for possible dismissal) should be made more lenient. Care should be taken, however, not to lessen punishment without taking other forceful action to reduce avail- ability of alcohol before and on the job, including a before-work "dry" period and regular supervisory checks. To reduce possible punishments alone could take on a symbolic meanin~that on-the-job drinking is an accepted practice. Continuation of current rules, which are widely violated and whose violations are seldom reported, does not serve treatment programs and offers few benefits other than convenience and the appearance of con- cern. Given the industry's reluctance to change its policies, the FRA's lack of initiative appears negligent at best. Employee Practices As discussed earlier, the lack of sick leave, the "on-call" status for those who have been off duty 8 hours, and the extensive use of away-from-home layovers all contribute to alcohol prob- lems among railroad employees. Reforms in these work conditions, which represent a classic example of reforming environmental factors rather than drinking behavior per se (as discussed earlier), could provide new strategies for reducing alcohol-related problems. It should be noted that other modern industries have either abandoned or limited most of these practices. Although it might be difficult or impossible to eliminate away-from-home layovers, it might still be possible to emphasize sched-

The Role of Nonalcohol Agencies 445 uling so that crews are given round-trip daily assignments. The primary arguments against this are the convenience and short-term efficiency of the existing schedules weak rationales, considering the potential safety dangers. Reforms in Safety Equipment The NTSB has recommended that "dead-man" controls be required on trains. This device, which was once a common part of railroad equipment, automatically stops a train when not depressed or held. Thus, an engineer is required to actively hold the control, and if he falls asleep, becomes drowsy or loses motor control (common attributes of heavy drinking), the train stops. The FRA, in response to our inquiries, stated that no regulation will be forthcoming because such controls are "not cost-effective." One serious accident involving hazardous chemicals would undoubtedly change the equation being used. We were unable, within the scope of this study, to determine the feasibility of such a device. Certainly, further study is indicated. At a minimum, the potential use of "dead-man" controls on trains that carry hazardous materials should be investigated. The FRA has repeatedly failed to act on these and similar recom- mendations. NIAAA initiatives are therefore likely to find a reluctant, if not hostile, agency. Nevertheless, providing support to the NTSB, which is currently conducting various investigations, may well be ben- eficial. Given the potential dangers and the extent of alcohol use and abuse, it is imperative that alcohol policy makers enter this arena, at least to open debate and discussion. FEDERAL ECONOMIC-BASED JURISDICTION INTRODUCTION Previous sections of this paper have emphasized the participation of various federal agencies in regulating the consequences of alcohol con- sumption and the availability of alcohol at the retail level. However, the discussion has tended to ignore federal economic powers over the avail- ability of alcohol and the alcohol production industry. The Bureau of Alcohol, Tobacco, and Firearms is the primary agency exercising economic controls, through excise and import taxes on alcohol beverages themselves as well as other economic levers. Indeed, the federal taxing power has been a focus of recent proposals in the field of alcohol problems prevention. Several researchers have argued that raising government taxes on alcohol would reduce alcohol consumption

446 MOSHER and MOTTL and alcohol-related problems (e.g. Bruun et al. 1975, Popham et al. 1975, 1976~. As indicated earlier, BATF regulations are beyond the scope of this study. However, various other agencies exercise economic controls on alcohol. For example, military pricing policies (which have been dis- cussed previously) are a form of economic control. The Federal Trade Commission (FTC), through its antitrust powers, has recently acted to prohibit various illegal business practices by alcohol producers.28 Be- cause they involve producers' attempts to influence retail practices, the FTC powers could have an effect on the availability of alcohol generally. The relationship of governmental economic policies (other than tax policy) and alcohol problems has been largely ignored in current liter- ature, although a recent study of California practices provides some insights (Bunce 1979, Morgan 1980~. For our purposes, two agencies, the Internal Revenue Service and the Small Business Administration, are briefly examined to highlight the extent and variety of governmental economic regulations and to suggest that they may be an important component of an overall policy to prevent alcohol problems. Our pur- pose is to suggest new areas of potential research and debate rather than to make concrete proposals for reform. INTERNAL REVENUE SERVICE29 Although the Internal Revenue Service (IRS) has only indirect control over drinking behavior, it still wields considerable influence. Tax law may have very significant indirect effects on all aspects of American life, such as decisions to get married or divorced, basic decisions concerning how to conduct a business, and the price of a concert ticket. At least three aspects of the IRS tax code have an economic impact on drinking practices and marketing techniques. (1) Business gifts. The Tax Code permits deductions for gifts related to one's business not to exceed $25. Gifts up to $100 given to employees for years of service or safety achievements may be deducted. These 28 See In the Matter of Heublein, Inc., Allied Grape Growers, United Vintners, Inc., Heublein Allied Vintners, Inc., Federal Trade Commission initial Decision, July 2' 1979, pares. 258, 643 (Docket No. 8904~; Bunce (1979, pp. 55-56~. BATF and the Security Exchange Commission also have authority over illegal business practices by alcohol pro- ducers. See, e.g., BATF. Offer in Compromise by Anheuser-Busch, Inc., March 30, 1978, Announcement 78-48. 29 For a thorough discussion and analysis of the "business" alcohol market and federal tax policy. see Mosher (1980~.

The Role of Nonalcohol Agencies 447 provisions implicitly include gifts of alcoholic beverages. Alcoholic re- tailers and manufacturers may also give away tax-free samples in order to promote their products. (2) Advertising deductions. Alcohol producers, like other businesses, are permitted to deduct all advertising expenses as a cost of doing busi- ness. Because of the size of producers' advertising budgets, these de- ductions amount to a very large tax break, although the exact amount is unavailable.30 In effect, they provide governmental encouragement of alcohol advertising, which appears to conflict at least symbolically with NIAAA efforts to promote a media campaign on the dangers of alcohol. (3) Business entertainment and meals. The Tax Code provides that expenses for food and beverage furnished to any individual under cir- cumstances that are "a type generally considered to be conducive to a business discussion' may be classed as a business expense and thus deducted from gross income for tax purposes. Alcohol served as a form of entertainment may also be deducted if a "business" connection can be established. Although such expenses must be "ordinary and neces- sary" in the conduct of the business, the code specifically states that expenses to promote good will (which can include buying alcoholic bev- erages) are permissible. Employers may also claim business deductions for food and beverages served on business premises primarily for the benefit of their employees. The IRS regulations, designed to implement the Tax Code, make the business drinking deductions even broader. It states that there is no requirement that business actually be discussed for the deduction to apply so long as the surroundings are such that they provide an atmos- phere in which there are no substantial distractions to discussions gen- erally (i.e., no floor shows, etc.~. Further, the deduction may be claimed for beverage expenses apart from meals, for example, at cocktail lounges or hotel bars. The regulations provide no limits on the number of drinks that may be deducted in one setting or in one day. Rather, claims for deductions are challenged only if there is inadequate documentation of cost or business purpose. 3"According to a U.S. Senate hearing, the alcoholic beverage industry spent over $20~} million in advertising in 1974 (U.S. Congress 1976). Advertising expenditures have in- creased dramatically since that time. For example Anheuser-Busch's advertising budget increased from $49 million in 1976 to $115 million in 197g (O'Hanlon 1979). O'Hanlon states that the trend toward increased advertising expenditures is continuing to accelerate. The distilled spirits industry, which is prohibited by trade agreement from advertising on broadcast media by trade agreement. spent $81 million in magazine advertising alone in 1976, 5 percent of all magazine revenues for that year (Advertising Age. January 31. 1977).

448 MOSHER and MOTTL These business drinking policies can condone serious abuses. For example, potential sellers of goods may try to ply buyers with alcohol in order to loosen their judgment and increase sales. This practice, although unethical and perhaps illegal, appears to be a tax deductible expense. In fact, it appears that alcohol consumption at business con- ventions or other business meetings or trips can generally be claimed as deductions provided that a business associate is included in the drink- . · , sing episode. The IRS does not compile the amounts claimed by taxpayers for particular types of tax deductions. The Bureau of Economic Analysis (U.S. Department of Commerce) estimates that U.S. corporations and federal, state, and local governments spent an aggregate of $10 billion on alcohol in 1979 (Mosher 1980~. The alcohol industry estimates that at least two-thirds of this amount ($6.7 billion in 1979) can be attributed to corporate purchases (Spirits Magazine 1960~. Virtually all of this expense can be assumed to have been taken as a business tax deduction, saving corporations approximately $2.7 billion on their tax returns. This amount must be supplemented by alcohol deductions taken by individual taxpayers, for which there are no available estimates. Tax savings for business use of alcohol probably total between $4 and $7 billion annually (Mosher 1980~. Most corporate purchases result in drinking without cost, since the corporation, a fictitious entity, pays the expense and provides the alcohol to employees, associates, guests, and customers, usually without reim- bursement. This is particularly important in light of current policy pro- posals to raise the price of alcohol as a means to reduce alcohol-related problems (e.g., Bruun et al. 1975; Popham et al. 1975, 1976~. Business lunch deductions became a political issue early in the Carter Administration as a symbol of unfair "tax loopholes." Mistermed the "three-martini lunch" (an inaccurate characterization because any num- ber of drinks may be deducted), the issue was presented as a tax loophole rather than a public health issue and the proposal was eventually dropped for lack of support. The administration failed to separate the issue of alcohol deductions from meal deductions generally. Tax policies reflect conscious decisions concerning governmental priorities, and changes are often made in tax deductions in order to encourage or discourage particular business and consumer practices. Tax deductions are considered "indirect government subsidization of activities" by tax analysts (Mosher 1980, p. 3) and provide an important means for establishing government priorities. For example, consumers can no longer deduct gasoline taxes on their returns, reflecting the government's increasing concern for reducing, or at least not encour-

The Role of Nonalcohol Agencies 449 aging, gas consumption. Child care expenses, once not deductible, are now deductible, but only if both parents are gainfully employed or seeking employment. A parent's decision to engage in volunteer work will not qualify for obtaining the deduction. This could be viewed as a partial accommodation to the women's movement. Public health policies are also reflected in Tax Code provisions and IRS regulatory decisions. For example, part but not all of a family's medical budget is deductible. Certain types of treatment, deemed un- scientific, are excluded. Donations to certain public health organizations may be deducted. Businesses that provide various health benefits or services to employees may deduct these expenses. Thus, there is a strong precedent for translating governmental objec- tives, including public health priorities, into tax deduction policy. A public health perspective provides a strong rationale for examining the alcohol deductions. Present policies act to encourage providing drinks to business associates in a variety of settings, place no limit on the amount of drinking that is appropriate, are an indirect discount on the price of alcohol, and promote extensive advertising of alcohol products. They establish as a government policy, in conflict with policies advanced by NIAAA, that the service of alcohol is an "ordinary and necessary" part of various business dealings. Perhaps most ironically, a tax deduc- tion can be claimed for providing a gift of alcohol to an employee in recognition of his or her safety achievements. A number of possible reforms could be considered in an attempt to realign tax policy with NIAAA priorities. For example, limits could be placed on the number of drinks permitted on one business occasion or the places that may be frequented. More sweeping reforms are also available, such as declaring that the use of alcohol is not an ordinary and necessary business expense in any circumstance. Such proposals are highly political and may generate strong opposition from restaurant and business groups. Although the IRS could, through regulation, implement at least minimal reforms, congressional direction would probably be needed. However, if one views alcohol deductions as a public health issue and analyzes their implications for NIAAA initiatives (at least on a symbolic level), airing the issue might provide a valuable educational tool. SMALL BUSINESS ADMINISTRATION The Small Business Administration (SBA) is fundamentally concerned with aiding, counseling, and assisting small businesses. It does so pri-

450 MOSHER and MOTTL marily by offering loans and by ensuring that small businesses receive a fair proportion of government purchases and contracts. SBA loans are divided into two categories direct loans to small busi- nesses (Article 7a of the SBA Act) and loans to small business invest- ment corporations (SBIC), which, in turn, provide loans to small busi- ness concerns. The direct loans are usually in the form of bank guarantees the borrower obtains the loan from a private bank, and the SBA acts as guarantor. Until approximately 1968, SBA regulations pro- hibited the granting of any loan (including SBIC loans) to any business that received more than 50 percent of its gross receipts from alcoholic beverages. The regulation was repealed by order of the SBA adminis- trator by publication in the Federal Register. SBA personnel today state that the change was due to the administrator's decision that alcoholic beverage outlets were no longer considered suspect businesses and were entitled to the benefits received by other small businesses. Lobbying efforts were not a factor in the decision, according to current personnel. . The regulatory revision took place during the ghetto riots of the late 1960s. Many ghetto businesses were burned and looted, and the SBA received many applications for assistance. Coincidentally, liquor stores and bars made up a large part of the businesses affected by the civil disturbances. Liquor establishments are one of the few small businesses that have proven to be successful with minority proprietorship. Cer- tainly, civil rights concerns in the late 1960s had at least some influence in the decision to make loans available to liquor stores and bars. In addition, the timing coincided with nationwide policies that dramatically increased the availability of alcoholic beverages. Current figures on direct loans granted by SBA indicate that alcoholic beverage businesses obtain a significant portion of SBA financing, par- ticularly among minority applicants. For fiscal 1978, 636 loans amounting to $48 million were granted to bars and liquor stores, and 40 loans ($7.5 million) were granted to alcoholic beverage wholesalers. Of these, 262 loans (162 of which were liquor stores) were granted to minority ap- plicants. This means that 2.1 percent of all SBA loans and 4.3 percent of all minority loans involved alcoholic beverage distribution. The per- centage of alcoholic beverage concerns that have minority ownership is particularly striking: 38.8 percent of alcoholic beverage loans (and 50.9 percent of liquor store loans) went to minority applicants, compared with 18.9 percent of nonalcoholic beverage loans. At the end of fiscal 1978, SBA had outstanding direct loans to 1,764 alcoholic beverage businesses, 1,060 of which were liquor stores. SBA officials state that there are no longer any special considerations for or restrictions on bars and liquor store applications except for those

The Role of Nonalcohol Agencies 451 that might affect their potential for financial success. Applications are considered on an individual merit basis, and there are no records kept to determine the default rate of loans by the type of business. As these statistics show, SBA has a significant involvement in the establishment of new alcoholic beverage outlets throughout the country. Yet its staff has no concern with alcohol-related problems and no contact with the policies of NIAAA. SBA policies provide a case study of conflicting federal policies (in this case, alcohol beverage control versus promotion of minority business) in which alcohol policy makers have had no input. SBA could provide a source of information for evaluating the retail trade in alcoholic beverages through the study of loan repayment sta- tistics. Many proposals for reform in the retail trade could be made conditions for SBA financing. For example, mandatory training of on- premise sales personnel or requirements that establishments maintain certain hours, be located off main highways, or provide for alternative modes of transportation could be required for a loan to be granted. These restrictions could be made on an experimental basis to determine whether they have a beneficial effect on alcohol-related problems. Such reforms could provide important new research data at minimal costs. CONCLUSION Perhaps the most important finding of this study is that significant por- tions of federal authority to regulate the availability of alcohol and to respond to alcohol-related problems rest with federal agencies not usu- ally associated with alcohol policy. This has resulted in little or no coordination in the development of the federal response to alcohol, particularly in the area of prevention. In some cases, contradictory pol- icies are being made and enforced; in others, promising new prevention strategies (and potential new allies) are not being pursued. This paper has outlined the scope of federal authority, the important actors, and the potential impact of new strategies of prevention policy. Determining which actors should be approached and what strategies are appropriate is dependent on several factors. First, the current pol- icies of particular agencies can be examined to determine whether al- cohol is already considered within an agency's realm of responsibility. The Department of Defense, for example, is already operating an ex- tensive alcoholic beverage market as well as large prevention and treat- ment programs. Alcohol is perceived both within and outside the services as a source of serious problems that the military must contend with in order to fulfill its military responsibilities effectively.

452 MOSHER and MOTTE In other cases, the relevance of alcohol to the agency's mission may exist, but the agency does not yet acknowledge the relationship of al- cohol issues to its decisions. For example, the IRS does not consider itself involved with alcohol policy, yet its actions have an impact on the perception of alcohol in the population, at least on a symbolic level. If a particular agency is already addressing alcohol issues, political support and recommendations for improvement or further study can be offered. For example, the military may provide an excellent opportunity to learn more about the relationship of alcohol availability and alcohol- related problems, and experimental programs may be appropriate. In some cases, however, a first step may be necessary—convincing an agency that its actions do in fact have an impact on federal alcohol . . pa lcles. In many cases described in this paper, agencies with the capacity to address alcohol-related issues do not view alcohol as part of their man- date. This may be justified. For example, alcohol issues are insignificant to the main goals of the Bureau of Land Management and. the National Park Service. Despite their supervision of a modest alcohol retail trade and their concern for at least some alcohol-related problems (e.g., drunk driving), they have only minimal enforcement and supervisory capacity and have important, unrelated responsibilities. A particular agency's view of its own responsibilities may conflict, however, with a significant part of its statutory duties. For example, the Consumer Product Safety Commission is mandated to provide useful and extensive statistical data on the cases of accidents involving con- sumer products. Its accident forms and collection procedures virtually ensure that this responsibility cannot be met, particularly as to alcohol involvement. In fact, the commission in the past has considered alcohol as outside its scope of responsibility altogether, despite this statutory directive. The Federal Railroad Administration's duty to ensure safe rail transportation appears to be significantly hampered by its failure to determine the extent of alcohol involvement in accidents, particularly given the recent study of drinking among railroad employees. Agencies with overlapping responsibilities may fail to act, relying on others to do so: for example, the National Transportation Safety Board and the Department of Transportation, in regard to the general study of alcohol involvement in transportation accidents. When a particular agency is not meeting statutory responsibilities, strategies that attempt to initiate policy changes and new programs may be appropriate. The tactics relied on depend on a given agency's current financial and political situation and its likely response. Alcohol policy makers in some instances may have to take as a first step simply opening

The Role of Nonalcoho! Agencies 453 an issue for debate, hoping that alliances can be formed and attitudes changed. More concrete actions may be appropriate if an agency is likely to be responsive. Coordinating federal alcohol policy may in some cases require direct contacts with particular agencies or interested third parties. In others, however, there may be issues common to more than one agency. For example, a common thread through most of this paper concerns the need for better statistical analysis from a variety of federal agencies. Here, an interagency approach may prove to be useful. NIAAA is currently mandated by law to coordinate the Interagency Committee on Federal Activities for Alcohol Abuse and Alcoholism, which includes a prevention subcommittee. However, the full committee as presently constituted does not include many of the agencies discussed in this paper. Its emphasis has been on coordinating treatment efforts rather than on prevention; and it has not attracted attendance by high-level officials. This committee may have potential usefulness. However, if it is relied on as a means to address some of the strategies discussed in this report, NIAAA will need to place renewed emphasis on improving its effec- tiveness. Agency responsibilities, according to the agency's own perception and according to its statutory mandate, will be important factors in evaluating new strategies associated with nonalcohol-specific agencies. If NIAAA decides that coordinating alcohol prevention policies among agencies with significant alcohol-related responsibilities is part of its mission, it will need to devote long-term staff and financial support to the effort. Important new contacts will be necessary, either directly with particular agencies, or through a committee approach. The process of implemen- tation requires both negotiation and careful analysis of costs and possible opposition. We hope that our preliminary contacts and analysis provide a sound basis for further research and study. REFERENCES Aarens, M., Cameron, T., Roizen, J., Roizen, R., Room, R., Schnebeck D., Wingard, D. (1977) Alcohol, Casualties and Crime. Berkeley, Calif.: Social Research Group. Berl, W., and Halpin, B. (1978) Human Fatalities from Unwanted Fires. Laurel, Md.: John Hopkins University Applied Physics Laboratory. BNun, K., Edwards, G., Lumio, M., Makela, K., Pan, L., Popham, R., Room, R., Schmidt, W., Skog, O., Sulkunen, P., Osterberg, E. (1975) Alcohol Control Policies in Public Health Perspective. Helsinki, Finland: The Finnish Foundation for Alcohol Studies. Bunce, R. (1979) The Political Economy of California's Wine Industry. Berkeley, Calif.: Social Research Group. Cahalan, D. Cisin, I., and Crossley, H. (1969) American Drinking Practices: A National

454 MOSHER and MOTT' Survey of Drinking Behavior and Attitudes. New Brunswick, N.J.: Rutgers Center of Alcohol Studies. Cahalan, D., Cisin, I., Gardner, G., Smith, G. (~1972) Drinking Practices and Problems in the U.S. Army, 1972. Information Concepts, Inc., Report No. 73-6. Washington, D.C.: Information Concepts, Inc. Cahalan, D., and Cisin, I. (1975) Final Report on a Service Survey of Attitudes and Behavior of Naval Personnel Concerning Alcohol and Problem Drinking. Washington, I).C.: Bureau of Social Science Research. CSB Radio (1979) Special: Up in Smoke Cigarettes and Safety. May 26, 1979, 8:30-8:54 p.m., E.D.T. New York City, N.Y. CBS News. Comptroller General of the U.S. (1976a) Report to Congress: Alcohol Abuse Is More Prevalent in the Military Than Drug Abuse. MWD-76-99, April 8, 1976. Washington, D.C.: General Accounting Office. Comptroller General of the U.S. (1976b) Report to Congress: The Consumer Product Safety Commission Should Act More Promptly to Protect the Public from Hazardous Products. HRI)-78-122, June 1, 1976. Washington, D.C.: General Accounting Office. Comptroller General of the U.S. (1977) Report to Congress: The Consumer Product Safety Commission Needs to insure Safety Standards Faster. HRD-78-3, December 12, 1977. Washington, D.C.: General Accounting Office. Comptroller General of the U.S. (1978a) Report to Congress: Stronger Federal Aviation Administration Requirements Needed to Identify and Reduce Alcohol Use Among Ci- vilian Pilots. CED-78-58, March 20, 1978. Washington, D.C.: General Accounting Office. Comptroller General of the U.S. (1978b) Report to Congress: The Consumer Product Safety Commission Has No Assurance That Product Defects Are Being Reported and Corrected. HRD-78-48. Washington, D.C.: General Accounting Office. Comptroller General of the U.S. (1979a) Report to Congress: Changes Needed in Operating Military Clubs and Alcohol Package Stores, Volume I and II. FPCD-79-7, January 15, 1979 and April 23, 1979. Washington, D.C.: General Accounting Office. Comptroller General of the U.S. (1979b) GAO Staff Report: The Tax Status of Federal Resale Activities: Issues and Alternatives. FPCD-79-19, April 19, 1979. Washington, D.C.: General Accounting Office. Consumer Product Safety Commission (1978) HIA Hazard Analysis Report, Upholstered Furniture Flammability 1978. Washington, D.C.: Consumer Product Safety Commis- sion. Dooley, D., and Masher, J. (1978) Alcohol and legal negligence. Contemporary Drug Problems 7~2~:145-179. Douglass R.' and Freedman, J. (1977) Alcohol Related Casualties and Beverage Market Response to Beverage Alcohol Availability Policies in Michigan: Final Report Ann Arbor, Mich.: Highway Safety Research Institute, University of Michigan. Federal Aviation Administration (1976) Alcoholism and Airline Flight Crewmembers. Office of Aviation Medicine, Memorandum, November 10, 1976. Washington, D.C.: Federal Aviation Administration. Federal Railroad Administration (1976) AccidentlIncident Bulletin, Calendar Year 1976 No. 144. Washington, D.C.: U.S. Department of Transportation. Federal Railroad Administration (1977) Accidentllncident Bulletin, Calendar Year 1976 No. 145. Washington, D.C.: U.S. Department of Transportation. Federal Railroad Administration (1978) AccidentlIncident Bulletin, Calendar Year 1976 No. 146. Washington, D.C.: U.S. Department of Transportation.

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456 MOSHER and MOTTL Mosher, J. (1979a) Dram shop liability and the prevention of alcohol-related problems. Journal of Studies on Alcohol 40~9~:773-798. Mosher, J. (1979b) Alcohol Beverage Control System in California. Unpublished paper. Social Research Group, Berlceley, Calif. Mosher, J. (1979c) Retail Distribution of Alcoholic Beverages in California. Unpublished paper. Social Research Group, Berkeley, Calif. Mosher, J., and Wallack, L. (1979) The DUI Project: A Description of an Experimental Program to Address Drinking-Driving Problems. Sacramento, Calif.: California De- partment of Alcoholic Beverage Control. Mosher, J. (1980) Alcoholic Beverages on Tax Deductible Business Expenses: An Issue of Public Health Policy and Prevention Strategy. Unpublished paper. Social Research Group, Berkeley, Calif. National Transportation Safety Board (1974) Railroad Accident Report: Rear-End Col- lision of Two Southern Pacific Transportation Company Freight Trains, lndio, Califor- nia, June 25, 1973. Technical Report No. NTSB-RAR-74-1, adopted March 20, 1974. Washington, D.C.: National Transportation Safety Board. National Transportation Safety Board (1978) Annual Report to Congress 1977. Washing- ton, D.C.: National Transportation Safety Board. National Transportation Safety Board (1979a) Annual Report to Congress 1978. Wash- ington, D.C.: National Transportation Safety Board. National Transportation Safety Board (1979b) Marine Accident Report: Ferry MIV George Prince Collision with the Tanker S.S. Frosta (Norwegian) on the Mississippi River Lulingl Destrehan, Louisiana October 20, 1976. Technical Report No. NTSB-MAR-79-4, adopted March 22, 1979. Washington, D.C.: National Transportation Safety Board. National Transportation Safety Board (1980) Railroad Accident Report: Rear-End Col- lision of Two Southern Pacific Transportation Company Freight Trains, 02-Holat-21 and 01-BSM FK-20, Thousand Palms, California, July 24, 1979. Technical Report No. NTSB-RAR-74-1, adopted March 20, 1974. Washington, D.C.: National Transportation Safety Board. O'Hanlon, T. (1979) August Busch brews up a new spirit in St. Louis. Fortune Magazine, January 15:98. O'Malley, B. (1979) Cigarettes and sofas: How the tobacco lobby keeps the home fires burning. Mother Jones, July:56-62. O~rerbey, J. W. (1979) Letter of the Director, Analysis and Management Studies, United States Fire Administration to A. Jarvis, Legislative Assistant to Representative Moak- ley, September 5, 1979. Polich, J., and Orvis, B. (1979) Alcohol Problems: Patterns and Prevalence in the U.S. Air Force. R2308-AF, June 1979. Santa Monica, Calif.: Rand Corporation. Popham, R., Schmidt, W., and deLint, J. (1975) The prevention of alcoholism: Epide- miological studies of the effect of government control measures. British Journal of Addiction 70:125-144. Popham, R., Schmidt, W., and deLint, J. (1976) The effects of legal restraint on drinking. Pp. 597-625 in D. Kissin and H. Begleiter, eds., The Biology of Alcoholism, Volume 4: Social Aspects of Alcoholism. New York: Plenum Press. Room, R., and Mosher, J. (1979) A role for regulatory agencies in the prevention of alcohol problems. Alcohol and Health Research World 4~2~:11-18. Schuckit, M. (1977) Alcohol problems in the United States armed forces. Military Chap- lains Review (Winter):9-19. Spirits Magazine (1960) Is liquor's billion dollar business being recognized? Spirits, Oc- tober.

The Role of Nonalcohol Agencies 457 Stiehl, C. (1975) Alcohol and Pleasure Boat Operators: Final Report. No. CG-D-143-75. Washington, D.C.: U.S. Department of Transportation. U.S. Coast Guard (1979a) Boating Statistics, 1978. COMDTINST M16754.1. Washington, D.C.: U.S. Department of Transportation. U.S. Coast Guard (1979b) Statistics of Casualties, 1978. Washington, D.C.: U.S. Coast Guard. U.S. Congress (1976) Media Images of Alcohol: The Effects of Advertising and Other Media on Alcohol Abuse. Hearings before the Subcommittee on Alcoholism and Nar- cotics of the Committee on Labor and Public Welfare, United States Senate 94th Congress, March 8 and 11. Washington, D.C.: U.S. Government Printing Office. U.S. Congress (1978) Consumer Product Safety Commission. Hearing before the Sub- committee on Civil Service of the Committee on Post Office and Civil Service, March 9. House Document 95-68. 95th Congress, Second Session. Washington, D.C.. U.S. Government Printing Office. U.S. Department of Health, Education and Welfare (1972) Fourth Annual Report to the President and the Congress on the Studies of Death, Injuries, and Economic Losses Resulting from Accidental Burning of Products, Fabrics, or Related Materials. Wash- ington, D.C.: U.S. Department of Health, Education and Welfare. Waas, M. (1980) Life savers: Self-extinguishing cigarettes.Washington Post Sunday Out- look, June 1:2. APPENDIX RELEVANT REGULATIONS AND LAWS BY AGENCY National Park Service 36 Code of Federal Regulation ("CER") §§2.16, 5.2 Public Law 89-249, October 9, 1965; 79 Stat. 969-971 Bureau of Land Management 43 CFR §8363 Army Corps of Engineers Army Corps of Engineers Regulation 1130-2-400, May 28, 1971 Forest Service 36 CFR §§3.14, 4.6 Bureau of Indian Affiars Act of August 15, 1953, ch. 505 §2; 67 Stat. 586; 25 CFR §~11.1, 11.55 Department of Defense DOD Directive 1330.15, April 11, 1972 DOD Directive 1010.2, March 1, 1972 (as amended) DOD Instruction 1010.3, May 22, 1974

458 Army Regulation A210-65, December 1, 1978 Air Force Regulation 215-1, July 31, 1974 (as amended) Navy Manual for Messes Ashore NAVPERS 15951 U.S. Navy Regulations 1973, art. 1150 SECNAV Instruction 1700.11B, March 29, 1973 MOSHER and MOTTE Consumer Product Safety Commission Consumer Product Safety Act, Public Law 92-S73, October 27, 1972; 86 Stat. 1207 Nuclear Regulatory Commission 10 CFR §§55.11, 55.33 National Transportation Safety Board 49 U.S.C.A. §§1901 et seq. Federal Aviation Administration 14 CFR §§67.1-67.31, 91.11, 121, 575 Federal Railroad Administration Rail Safety Act of 1970 (Public Law 91-458, May 10, 1970) Coast Guard Public Law 92-75, August 10, 1971, 85 Stat. 214-226 46CFR §§10.1 et seq. Internal Revenue Service 26 U.S.C.A. §§162, 274 26 CFR §1.274.2 Small Business Administration none

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