Athens, Alabama Considers Alcohol Ban

From August 14, 2007 Associated Press:

A measure to end the sale of alcohol in Athens is up for a citywide vote, a rare instance where voters could overturn a previous vote to allow sales.

Business interests are against repeal, but church leaders who helped organize the petition drive that got the measure on the ballot are asking members to pray and fast in support of a ban.

Christians who oppose drinking on moral grounds believe they have a chance to win, however small.

"If it can be voted out anywhere, it will be here because so many Christians are against it," said Teresa Thomas, who works in a Christian book store.

Business leaders argue that ending the sale of beer, wine and liquor would hurt tax revenues and send the message that Athens is backward.
"Economic impact is really the big issue," said Carl Hunt, an
organizer of the pro-alcohol sale Citizens for Economic Progress.

The news story also mentioned that Barrow, Alaska had banned alcohol at one point:

Such "wet-to-dry" votes aren't unheard of, but they're rare, said Jim Mosher of the Pacific Institute for Research and Evaluation, which tracks public policy issues including alcohol laws.

"In Barrow, Alaska, when they legalized alcohol sales, problems went through the roof," Mosher said. "Then, when they banned it again, it improved."

I did a small amount of searching, and found this abstract from a Journal of the American Medical Association article about Barrow:

CONTEXT: Community availability of alcohol affects alcohol consumption patterns and alcohol-related health and social problems. In Barrow, Alaska, an isolated community at the northernmost reaches of the United States, during a 33-month period, possession and importation of alcohol were legal, completely banned, made legal again, and then banned again.

OBJECTIVE: To determine the impact of these public policy changes on alcohol-related outpatient visits at the area hospital.

DESIGN: Retrospective review of outpatient records; time-series analysis of alcohol-related visits with respect to community alcohol policy.

MAIN OUTCOME MEASURES: Total monthly outpatient visits for alcohol-related problems.

RESULTS: There was a substantial decrease in the number of alcohol-related outpatient visits when the ban on possession and importation was imposed compared with baseline. When the ban was lifted, outpatient visits increased; when the ban was reimposed, the number of outpatient visits again decreased. Interrupted time-series analyses confirm that the alcohol ban, its lifting, and its reimposition had a statistically significant and negative effect on the number of alcohol-related outpatient visits (P<.05).

CONCLUSION: In a geographically isolated community, the prohibition of alcohol can be an effective public health intervention, reducing the health problems associated with alcohol use.

This must have been a quite remarkable political struggle--to have it legal, then banned, made legal again, then banned again--all in 33 months! It also provided a nearly perfect opportunity to do a statistical evaluation of short-lived changes in behavior.

THis many changes in 33 months is too rapid to measure long-term changes in behavior. For example, I've seen graphs of U.S. cirrhosis of the liver death rates for the twentieth century. About 95% of cirrhosis of the liver cases are alcohol-related; within a few years of Prohibition's passage (remember that state bans preceeded national Prohibition by several years), death rates were cut in half; within a few years of Prohibition's repeal, death rates rose to the pre-Prohibition levels (see Figure 2). (See also this letter by a Yale professor to the New York Times confirming this.) Even those arguing against Prohibition admit this:

While the U.S. death rate from cirrhosis of the liver (a consequence almost exclusively of alcoholism) dropped 50% during Prohibition (suggesting a 50% decline in alcohol consumption, it increased again to pre-Prohibition levels by the 1960s.

As the abstract points out, Barrow was an isolated community; this makes it practical for a ban to have a substantial impact. Barrow is also a community which is heavily Native American, and doubtless this aggravates the problems associated with alcohol.

I'm not a big fan of prohibiting either alcohol or drugs. But pretending that laws don't change behavior is, at best, naive. There can be destructive effects from prohibition that may be worse than the substance abuse problem itself, but pretending that these laws have no positive benefits is delusion.