Drinking Environments

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Valerie Payne
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1 Drinking Environments Karen Hughes Centre for Public Health, Liverpool John Moores University WHO Collaborating Centre for Violence Prevention Ninette van Hasselt & Lotte Voorham Trimbos Institut, Netherlands Montse Juan European Institute for Studies on Prevention, Spain Matej Kosir Utrip, Slovenia

2 Workshop Structure Overview of Evidence AMPHORA study Effective interventions? Staff training Bar management Policy and legislation Discussion Key points to feed back

3 European Alcohol Action Plan Recognises importance of drinking environments Alcohol use and intoxication Violence, injury, drink driving... Develop guidelines and standards: Design of serving premises Server training Enforcing licensing laws Review and strengthen licensing laws Premises meet established standards Server training Regular monitoring and enforcement Sufficiently severe sanctions

4 AMPHORA study European evidence base poorly developed Most studies from N America & Australia What does nightlife look like in Europe? AMPHORA study Liverpool, Ljubljana, Palma, Utrecht Survey and breathalyser test ~200 nightlife users in each city (age 16-35) Peak nightlife hours Streets outside bars Observational study in bars Structured observational tool, ~60 visits per city

5 % Preloading on the night of survey Botellon Preload Slovenia Spain Netherlands UK Hughes et al, 2011

00 How do Double you vodka prevent intoxication and

6 Price of alcohol, Great Britain, 2009 Off Trade Standard glass of wine On Trade How do Double you vodka prevent intoxication and service of alcohol to drunk people when they arrive in nightlife already drunk?

7 Grams of alcohol Alcohol consumption before and after survey Majority binge drinking >60% in Slovenia and Spain >80% in UK and Netherlands AFTER BEFORE 20 0 Netherlands Slovenia Spain UK Netherlands Slovenia Spain UK Female Male

Slovenia Spain UK? How transferable are interventions in different drinking cultures?

8 Slovenia Spain Netherlands UK %BAC % Nightlife BAC Males 0,18 0,16 0,14 0,12 0,10 0,08 0,06 0,04 0,02 0,00 % having preloaded on survey night Hours since started drinking Botellon Preload Less than 3 hours 3 to 5 hours More than 5 hours Netherlands Slovenia Spain UK? How transferable are interventions in different drinking cultures? Many interventions developed and tested in heavy drinking cultures How do we prevent the spread of intoxicated nightlife? What can we learn from more moderate drinking cultures? Hughes et al, 2011

9 Evidence a brief summary Responsible beverage service Alone, no clear evidence of effectiveness for reductions in alcohol consumption levels or responsible serving practice Combined with enforcement and awareness raising can be effective Enforcement activity Test purchasing for underage sales Effects rapidly reduce High profile policing No real evidence of effectiveness Targeting policing in high risk premises Can reduce violence Holder and Wagenaar, 1994; Wallin et al, 2005; Wagenaar et al, 2005; Wiggers et al, 2004

Environmental Measures Improving management of venues Risk assessment, codes of practice, behavioural standards Currently little evidence

10 Environmental Measures Improving management of venues Risk assessment, codes of practice, behavioural standards Currently little evidence AMPHORA study Poor management practice Harm reduction Outside bars Safe late night transport Security Taxi marshalls, CCTV, policing Street lighting

Community Approaches Multi-agency partnerships, multi-component Typically comprise: Community mobilisation Server training Enforcement Media campaigns Can be

11 Community Approaches Multi-agency partnerships, multi-component Typically comprise: Community mobilisation Server training Enforcement Media campaigns Can be effective in reducing: Assaults, traffic crashes, underage sales STAD, Sweden PAKKA, Finland Wallin et al, 2003; Månsdotter et al, 2007; Warpenius et al, 2010

12 Australia Environmental Measures High visibility policing Safer drinking campaign CCTV Radio communication ID scanners in bars No impact on alcohol-related injuries Broader measures required Need to address intoxication, not just harms Miller et al, 2011

13 Licensing Legislation Density of bars and clubs Increased numbers lead to increased violence, road traffic crashes. Very difficult to reduce Alcohol prices prices, harm Discrepancy between on and off licensed premises Hours of sales hours alcohol-related harm But increased in several countries Australia reduced hours in one city due to complaints reduced assaults

14 Issues for Europe Need to develop European evidence How transferable are our interventions? What can we learn from each other? How can we prevent the spread of intoxigenic nightlife? How do we deal with preloading? How do we get the best from our nightlife? Powerful alcohol industry Fluid nightlife industry

Drink Less Enjoy More Intervention Evaluation Liverpool, UK

Drink Less Enjoy More Intervention Evaluation Liverpool, UK Dr Zara Quigg Reader in Behavioural Epidemiology Public Health Institute, Liverpool John Moores University z.a.quigg@ljmu.ac.uk Background Drunkenness