Inclusion and Exclusion Criteria
To be included in this review, studies had to meet the
following criteria: First, they had to evaluate changes in outlet
density or policy changes that clearly resulted in changes in
outlet density. Studies of policy changes (e.g., privatization or
the legalization of liquor by the drink) had to provide
evidence that there was a corresponding change in alcohol
outlet density. Second, studies had to be conducted in
high-income nations,a,22 be primary research (rather than a
review of other research), and be published in English. Third,
studies had to report outcome measures indicative of excessive
alcohol consumption or related harms. Direct measures
that had the strongest association with excessive alcohol
consumption included binge drinking, heavy drinking, liver
cirrhosis mortality, alcohol-related medical admissions, and
alcohol-related motor-vehicle crashes, particularly singlevehicle
nighttime crashes, which are widely used to indicate
motor-vehicle crashes due to drinking and driving.23 Less
direct measures included per capita ethanol consumption,
which is a well-recognized proxy for the prevalence of heavy
drinkers in a population8,24; unintentional injuries; suicide;
and crime, such as homicide and aggravated assault. In most
studies included in this review, consumption is measured by
sales data; the team referred to this measure as “consumption”
and note the exceptional study in which self-reported
consumption is directly assessed. Fourth, studies had to be
published in a peer-reviewed journal or in a government
report. Reports not published or