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Alcohol Problems and Policies: the States Have the Power, But Will They Use It?
1School of Public Health, Boston University.
The Milbank Quarterly
|July 23, 2025
Summary
States have regulatory power over alcohol and can increase alcohol taxes to generate revenue and reduce alcohol-related harms. This can fund essential public health programs and services.
Area of Science:
- Public Health Policy
- Alcohol Regulation
Background:
- Following National Prohibition's repeal in 1933, states assumed primary regulatory authority over alcohol.
- Since the 1970s, state alcohol policies have generally liberalized, weakening control structures.
Purpose of the Study:
- To analyze the evolution of state-level alcohol control since 1933.
- To highlight opportunities for states to leverage alcohol taxes for revenue and public health improvement.
Main Methods:
- Historical policy analysis of state alcohol regulations.
- Examination of trends in alcohol taxes, availability, and marketing.
Main Results:
- State alcohol control has significantly liberalized since the 1970s.
- Alcohol taxes have not kept pace with inflation, and marketing controls are weak.
- States possess the authority to strengthen alcohol policies.
Conclusions:
- States can utilize alcohol taxes to generate revenue and mitigate alcohol-related problems.
- Increased alcohol taxes can fund vital public health programs and services, especially amid declining federal funding.
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