Preventing Excessive Alcohol Consumption: Privatization of Retail Alcohol Sales
The privatization of retail alcohol sales is the repeal of government (i.e., nation, state, county, city, or other geo-political unit) control over the retail sales of one or more types of alcoholic beverages, thus allowing commercial retailing of those beverages. States with government control of alcohol sales are referred to as control states, and states with privatized sale are referred to as license states. The privatization of retail alcohol sales generally applies only to off-premises alcohol outlets--retail locations, such as liquor stores, where alcoholic beverages are sold for consumption elsewhere. Privatization does not generally affect the retail sales of alcoholic beverages at on-premises alcohol outlets--locations such as bars and restaurants, where alcoholic beverages are sold for consumption on-site. Re-monopolization of retail alcohol sales is the re-establishment of government control over the retail sale of one or more types of alcoholic beverage.
Summary of Task Force Recommendations and Findings
Based on its charge to identify effective disease and injury prevention measures, the Community Preventive Services Task Force recommends against the further privatization of alcohol sales in settings with current government control of retail sales. This finding is based on strong evidence that privatization results in increased per capita alcohol consumption, a well-established proxy for excessive consumption.
The Task Force recommendation against privatization of retail alcohol sales is based solely on evidence related to public health consequences, which may be one of several factors to consider when making decisions on whether to privatize retail alcohol sales.
Results from the Systematic Review
Eighteen studies qualified for the systematic review.
- Seventeen studies assessed the effects of privatization on per capita alcohol sales, a well-established proxy for excessive alcohol consumption and related harms.
- Overall, there was a 44.4% median increase in per capita sales of privatized alcoholic beverages within the jurisdiction that underwent privatization during the years following privatization of retail alcohol sales (interquartile interval [IQI]: 4.5% to 122.5%; 17 studies).
- During this same time frame, sales of nonprivatized alcoholic beverages within the jurisdiction that underwent privatization decreased by a median of 2.2% (IQI: -6.6% to -0.1%; 9 studies).
- One study in Finland assessed the effects of privatization for groups reporting different levels of alcohol consumption. It found privatization increased consumption across all groups.
- One study in Sweden found that re-monopolizing the sale of medium-strength beer was associated with a general reduction in alcohol-related harms.
These results were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to excessive alcohol consumption and related harms.
- Analytic Framework [PDF - 194 kB]
- Summary Evidence Table* [PDF - 95 kB]
- Evidence Gaps
- Included Studies
Hahn RA, Middleton JC, Elder R, Brewer R, Fielding J, Naimi TS, Toomey TL, Chattopadhyay S, Lawrence B, Campbell CA, Community Preventive Services Task Force. Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a Community Guide systematic review [PDF - 321 kB]. Am J Prev Med 2012;42(4):418-27.
Community Preventive Services Task Force. Recommendations on privatization of alcohol retail sales and prevention of excessive alcohol consumption and related harms [PDF - 65 kB]. Am J Prev Med 2012;42(4):428-9.
Cook PJ. Alcohol retail privatization: a commentary [PDF - 71 kB]. Am J Prev Med 2012;42(4):430-2.
Read other Community Guide publications about Preventing Excessive Alcohol Consumption in our library.
Community Guide News
- Task Force Recommends Against Privatizing Retail Alcohol Sales
Developed by The Community Guide in collaboration with CDC’s Alcohol Program
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*PDF includes all of the information available and will not be updated.
The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Preventing excessive alcohol consumption: privatization of retail alcohol sales. www.thecommunityguide.org/alcohol/privatization.html. Last updated: MM/DD/YYYY.
Review completed: April 2011
- Page last reviewed: September 24, 2013
- Page last updated: June 18, 2015
- Content source: The Guide to Community Preventive Services