bership to public health, safety, and other noncommercial organizations. There is some evidence that coalition partners with strong ties to alcohol producers may not support effective environmental interventions. Government agencies may or may not play a major role.
Community-driven initiatives should be tailored to the specific problems and resources in a community. Different communities will therefore have different priorities based on their particular needs. For example, some research suggests that minority communities may be targeted by some alcohol advertisers (Alaniz and Wilkes, 1995; Altman et al., 1991; Hackbarth et al., 2001) and that outlet density in these communities is particularly high (LaVeist and Wallace, 2000; Gorman and Spear, 1997). Although a specific relationship between advertising and underage drinking has not been shown, recent cross-sectional research has shown a correlation between outlet density and underage drinking. For example, outlet density has been associated with increased incidence of youth driving under the influence (Treno, Grube, and Martin, 2003), ease of alcohol purchase (Freisthler et al., 2003) and heavy and frequent drinking and alcohol problems (Weitzman et al., 2003a). Similarly, Wechlser and Wuethrich (2002) suggest that controlling outlet density can help alleviate market pressures that result in discounted pricing, a factor in underage drinking.
Research has also shown that while newly arrived immigrants have lower rates of alcohol use than others, their consumption increases and they develop more liberal attitudes toward drinking as they become more acculturated (National Institute on Alcohol Abuse and Alcoholism, 1994; National Women’s Health Information Center, 2002). Communities should consider the variety of factors that may affect underage drinking, as well as the specific characteristics of underage drinking in their communities in developing community-specific strategies.
In large states, such as California, local coalitions have sometimes had greater success than statewide efforts. Other successful coalition efforts across the United States have been supported by statewide organizations or systems. States have organized regional coalitions consisting of representatives from institutions of higher education, city and state political officials, liquor control and licensing officials, state and local law enforcement officials, restaurant and tavern proprietors, state health officials, and researchers to support the development and implementation of broad and comprehensive strategies. The National Highway Traffic Safety Administration (2002) recently sponsored a project by the Pennsylvania Liquor Control Board to develop a manual to help alcohol beverage control (ABC) agencies identify opportunities and initiatives to reduce underage drinking.
Statewide initiatives can begin in a number of ways. Some are the result of the leadership of state agencies, such as the state department of public health or the state liquor control board. Others emerge through college and