OBJECTIVE U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time. The purposes of this study were to characterize the alcohol policy environment in each U.S. state and Washington, DC, in 2018, and to examine changes during the past 20 years. METHOD State-specific Alcohol Policy Scale (APS) scores from 1999 to 2018 were based on 29 policies, after weighting each present policy by its efficacy and degree of implementation. Modified APS scores were also calculated on the basis of two sets of mutually exclusive policy subgroups. RESULTS APS scores in 2018 varied considerably between states, ranging from 25.6 to 67.9 on a theoretical scale of 0 to 100; the median score was 43.5 (based on a 0-100 range), and 43 states had scores less than 50. The median change in state APS scores from 1999 to 2018 was positive (+4.9, range: -7.4 to +10.3), indicating increases in the restrictiveness of policy environments, with decreases in only five states. The increases in APS scores were primarily attributable to the implementation of stronger impaired-driving laws, whereas policies to reduce excessive drinking were unchanged. There was no correlation between states' excessive drinking policy scores and their impaired-driving scores (r = .05, p = .74). CONCLUSIONS Based on this policy scale, few states have restrictive policy environments. Although states adopted policies targeting impaired driving during the study period, there was no change in policies to reduce excessive drinking.

中文翻译：

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1999-2018年美国各州的酒类政策

目的美国决策者和公共卫生从业者缺乏评估和比较州级酒精政策环境的限制性的综合指标（指标），这些指标被概念化为在特定时间和地点存在多种政策。这项研究的目的是表征2018年美国各州和华盛顿特区的酒精政策环境，并研究过去20年的变化。方法1999年至2018年的州特定酒精饮料政策量表（APS）得分基于29项政策，然后根据其有效性和实施程度对每项现行政策进行加权。修改后的APS分数也基于两组互斥的政策子组进行计算。结果2018年各州的APS得分差异很大，范围从25.6到67。在0到100的理论范围内为9；平均得分为43.5（基于0-100范围），并且43个州的得分低于50。1999年至2018年，州APS得分的中位数变化为正（+4.9，范围：-7.4至+10.3），表示政策环境的限制有所增加，只有五个州有所减少。APS分数的提高主要归因于实施了更严格的无人驾驶法律，而减少过量饮酒的政策却没有改变。各州的过度饮酒政策得分与驾驶不便得分之间没有关联（r = .05，p = .74）。结论基于此政策规模，很少有州具有限制性政策环境。尽管各州在研究期间采取了针对不良驾驶的政策，