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Effectiveness: 3 Star Cost: Varies
Use: Varies
Time: Varies

MLDA-21 law enforcement is very limited in many communities (Hedlund et al., 2001). Enforcement can take several forms, as summarized by Stewart (1999):

  • Actions directed at alcohol vendors: Compliance checks to verify vendors will not sell to youth (the Alcohol- and Drug-Impaired Driving chapter, Section 6.3), “dram shop”[1] liability laws or responsible beverage service training laws.

  • Actions directed at youth: “Use and lose” laws that confiscate the driver’s license of an underage drinker, “Cops in Shops” directed at underage alcohol purchasers, law enforcement “party patrols” using party dispersal techniques, and penalties for using false identification.
  • Actions directed at adults: Beer keg registration laws, enforcement of laws prohibiting purchasing alcohol for youth, “shoulder tap” operations (in which decoy minors ask adults to purchase alcohol for them and if the adults comply, they are cited or arrested), and programs to penalize parents who provide alcohol to youth at parties.

Fell et al. (2016) found that nine laws that support enforcement of the MLDA-21 law significantly decreased fatal crash ratios of drinking to nondrinking drivers under 21. The nine MLDA-21 support laws are

(1) possession of alcohol,

(2) purchase of alcohol,

(3) use alcohol and lose your license,

(4) zero-tolerance .02 BAC limit for underage,

(5) age of bartender ≥ 21,

(6) State responsible beverage service program,

(7) fake identification support provisions for retailers,

(8) dram shop liability, and

(9) social host civil liability.

The study estimated that combined the nine MLDA-21 support laws save approximately 1,355 lives each year. However, only 5 States have enacted all nine laws. While these enforcement strategies have been used frequently, few have been evaluated. Several strategies are briefly described below, along with supporting research evidence.

“Use and lose” laws: These laws allow confiscation of the driver’s license or postpone licensure for a period of time for youth who violate a State MLDA-21 law. Ulmer et al. (2001) investigated “use and lose” law implementation and effects in Pennsylvania. License suspensions for violations of MLDA-21 appeared to reduce subsequent traffic violations and crashes. In a national study Fell et al. (2009) found “use and lose” laws were associated with a 5% decrease in fatal crashes among underage drivers. The study estimated that 165 lives would be saved each year if all States had these laws. “Use and lose” laws can be implemented quickly and inexpensively once enacted. To be effective, they should be publicized extensively. As of January 2018, 28 States and the District of Columbia had mandatory “use and lose” laws and another 8 States had “use and lose” authority that may be applied in varying circumstances. In Arkansas and Hawaii, “use and lose” laws have some mandatory and some discretionary sections (APIS, 2018a).

Keg registration laws: These laws link beer keg purchasers to identification numbers on the kegs, which provide a method of identifying adults who supply beer to parties attended by youth. As of January 2018 thirty States and the District of Columbia had mandatory keg registration laws (APIS, 2018b). Utah only permits the sale of kegs to authorized beer retailers to dispense beer on draft for consumption on the beer retailer’s premises. In a study on the effectiveness of these laws, keg registration was shown to be associated with reduced traffic fatality rates in 97 U.S. communities (Cohen et al., 2001). However, the authors could not conclude that keg registration caused the lower fatality rates. A study by Fell et al. (2015) found that keg registration laws were associated with decreases in per-capita beer consumption, but increases in the ratio of drinking to sober underage drivers involved in fatal crashes.

Media campaigns: Ohio has conducted statewide media campaigns, Parents Who Host Lose the Most, since 2000, and it is now also used in other States and communities. The campaign informs parents and youth about Ohio’s underage drinking laws and attempts to discourage parents from providing alcohol to underage drinkers at parties. Telephone surveys in 2006 showed that about 55% of parents and youth had heard messages about underage drinking (Applied Research Center, 2008). About two-thirds of those who had heard a message said that it prompted a conversation between parents and their teenagers about drinking. In comparison with surveys conducted in 2001, there was a 42% decrease among youth who reported knowing of parents who host parties where alcohol is served to teens.

Underage Drinking Tip line: In 2006 Kansas launched a statewide underage drinking tip line, 866-MustB21 and Pennsylvania uses 1-888-UNDER21. The toll-free tip lines operate 24 hours a day, 7 days a week, for people to report underage drinking parties, plans to purchase alcohol for underage people, and willingness of retailers to sell alcohol to underage people. The effect of the tip lines has not been evaluated. Nebraska introduced a statewide underage drinking tip line in 2009, using the same phone number as Kansas. States including New York, Texas, and Iowa have since implemented underage drinking tip lines.

Social Host Liability: Under social host laws, an adult who hosts an underage drinking party (specific laws), or who allow underage drinking to occur on that person’s property (general laws), can be held accountable if a young person is subsequently involved in a crash. This liability might discourage adults (parents, older siblings, and friends) from purchasing alcohol for underage people or hosting underage parties. Conducting source investigations where law enforcement teams identify providers of the alcohol, can be resource-intensive and time-consuming (Curtis & Ramirez, 2011). Moreover, the few research studies that have examined the effect of social host liability laws have obtained conflicting findings (Voas & Lacey, 2011). Nonetheless, comprehensive and well-publicized efforts to hold providers accountable appear to be promising. Social host laws, and their accompanying penalties, vary from State to State. A description of each State’s social host laws may be found in NHTSA’s Digest of Impaired Driving and Selected Beverage Control Laws (NHTSA, 2017). Another good resource is available from the Alcohol Policy Information System (2018c). As of January 2018 ten States have hosting laws specific to underage parties, and 21 States have general hosting laws (APIS, 2018c).

Comprehensive community programs: Community programs focus on changing the local environment to prevent alcohol abuse through changes in ordinances and norms, incorporating discrete counseling and prevention programs, or combinations of such strategies (Fagan et al., 2011). Several comprehensive community initiatives have reduced youth drinking and alcohol-related problems (Fagan et al., 2011; Hingson et al., 2004; Shults et al., 2009). These initiatives typically bring together several community government departments, such as schools, health, and law enforcement, with alcohol sellers, parents, youth, and citizen organizations (Fagan et al., 2011). They may include school-based programs, law enforcement, media, and other intervention strategies. They require strong leadership and organization. They may take many months to plan and implement. In particular, successful community initiatives are centered around data-driven practices and evidence-based measures, making the careful monitoring of program processes necessary to ensure quality outcomes.

The costs depend on the activities included; however, fiscal savings can be generated through the prevention of costs related to alcohol-abuse-related individual health and community expenses (Fagan et al., 2011). One example is a campaign conducted in Huntington, West Virginia, that included checkpoints to look for violations of the MLDA-21 law, checks of alcohol outlets to reduce sales to minors, and publicity for program activities. Roadside surveys conducted before and during the program showed a 93% drop in 16- to 20-year-old drivers having BACs greater than .05 g/dL (IIHS, 2008). Another promising program is Oregon’s Reducing Youth Access to Alcohol. The program involves community mobilization including “reward and reminder” visits (where vendors receive rewards if they decline to sell alcohol to a minor), regular compliance checks, enforcement of minor in possession laws, and media advocacy. The program has been effective in reducing the sale of alcohol to minors: successful purchase attempts by minors dropped from 24% before the program to 5% afterwards. Additionally, the individual communities with the strongest programs also experienced reductions in underage drinking (Flewelling et al., 2013). NHTSA has produced a guide on how communities can prevent underage drinking, available at:­20Guides%20HTML/Guides_index.html.


[1] The word “dram” has the same root as the Greek coin, a drachma, and was once a Greek unit of weight. In the 17th and 18th centuries British taverns called “dram shops” sold alcohol by the dram, then a unit of weight and roughly equivalent to a small teaspoon of liquid. It is now equivalent to 1/8 of an ounce and was used as a pharmaceutical measure even in the United States well into the 20th century. The Temperance Movement early in the 20th century used the term “dram shop” in its terminology opposing alcohol and the places that sold it, and the term became incorporated in law. A dram shop law usually holds the seller of alcohol – such as bar or tavern owner – responsible for a subsequent injury to an intoxicated person who bought alcohol from that vendor..