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Communities Mobilizing for Change on Alcohol

Ages 18-24

Rating: Level 2


Communities Mobilizing for Change on Alcohol (CMCA) is a community-organizing program designed to reduce young (18- to 24-year-old) adults’ access to alcohol by changing community policies and practices. Initiated in 1991, CMCA has proven that effectively limiting the access to alcohol of people under the legal drinking age not only directly reduces teen drinking but also communicates a clear message to the community that underage drinking is inappropriate and unacceptable. CMCA employs a range of social organizing techniques to address legal, institutional, social, and health issues to reduce youth alcohol use by eliminating illegal alcohol sales to youths by retailers and obstructing the provision of alcohol to youths by adults. The organizing process includes 1) assessing the community, 2) creating a core leadership group, 3) developing a plan of action, 4) building a mass base of support, 5) implementing the action plan, 6) maintaining the organization and institutionalizing change, and 7) evaluating changes. Program interventions target all community members. CMCA can be implemented in virtually any rural, suburban, or urban community.


CMCA was evaluated in a fully randomized 5-year research trial across 15 communities. Data was collected at baseline before random assignment of communities to the intervention or control condition and again at follow-up after a 2½-year intervention period. Data collection included in-school surveys of 9th and 12th graders, telephone surveys of 18- to 20-year-olds and alcohol merchants, direct testing (using underage youths who attempted purchases) of the likelihood of alcohol sales to youths, and monitoring changes in relevant practices of community institutions. Analyses were based on mixed-model regression, used the community as the unit of assignment, took into account the nesting of individual respondents or alcohol outlets within each community, and controlled for relevant covariates.


The evaluation results show that the CMCA intervention

  • Significantly and favorably affected the drinking behavior of 18- to 20-year-olds
  • Significantly and favorably affected the practices of establishments serving alcohol
  • Somewhat affected the off-sale alcohol establishments
  • Did not significantly affect high school seniors

Other outcomes include the following:

  • Alcohol merchants increased age-identification checking and reduced their propensity to sell to minors.
  • Older teenagers (18 to 20 years old) reduced their provision of alcohol to other teens and were less likely to try to buy alcohol or drink in a bar.
  • Arrests for driving under the influence of alcohol declined significantly among 18- to 20-year-olds.

Risk Factors


  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use


  • Availability of alcohol and other drugs
  • Low community attachment

Protective Factors


  • Healthy / Conventional beliefs and clear standards


  • Clear social norms / Policies with sanctions for violations and rewards for compliance
  • High expectations
  • Safe environment / Low neighborhood crime


  • SAMHSA: Model Programs


Wagenaar, Alexander C., John P. Gehan, Rhonda Jones–Webb, Traci L. Toomey, Jean L. Forster, Mark Wolfson, and David M. Murray. 1999. “Communities Mobilizing for Change on Alcohol: Lessons and Results From a 15-Community Randomized Trial.” Journal of Community Psychology 27(3):315–26.

Wagenaar, Alexander C., David M. Murray, John P. Gehan, Mark Wolfson, Jean L. Forster, Traci L. Toomey, Cheryl L. Perry, and Rhonda Jones–Webb. 2000. “Communities Mobilizing for Change on Alcohol: Outcomes From a Randomized Community Trial.” Journal of Studies on Alcohol 61:85–94.

Wagenaar, Aleaxnder C., David M. Murray, and Traci L. Toomey. 2000. “Communities Mobilizing for Change on Alcohol (CMCA): Effects of a Randomized Trial on Arrests and Traffic Crashes.” Addiction 95(2):209–17.

Wagenaar, Alexander C., David M. Murray, Mark Wolfson, Jean L. Forster, and John R. Finnegan. 1994. “Communities Mobilizing for Change on Alcohol: Design of a Randomized Community Trial.” Journal of Community Psychology 22(CSAP Special Issue):79–101.

Wagenaar, Alexander C., and Cheryl L. Perry. 1994. “Community Strategies for the Reduction of Youth Drinking: Theory and Application.” Journal of Research on Adolescence 4(2):319–45.


Alexander C. Wagenaar, Ph.D.
University of Florida, College of Medicine
1329 SW 16th Street, Room 5287
Dept of Epidemiology & Health Policy Research
Gainesville, FL 32608
Phone: (352) 265-7220
Fax: (352) 265-8047
Web site:

Technical Assistance Provider

David R. Greco, Vice President
Youth Leadership Insititute
246 First Street
Suite 400
San Francisco, CA 94105
Phone: (800) 954-8724
Fax: (415) 836-0071
Web site: