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• Community and drinking context
• Harm reduction around licensed serving establishments
• Implications for policy and prevention
• Conclusions
• Policy options
• References

The multitude of ways in which alcohol is consumed reflects the variety of roles drinking has across societies. Where people choose to drink is one of the many facets of drinking behavior. Much of alcohol consumption around the world occurs within people’s homes and personal space. Yet, drinking is also an integral part of social interaction in many cultures. Consequently, much of it also occurs in public settings and commercial venues (Heath, 2000; Oldenburg, 1999).

Drinking venues are an important aspect of drinking patterns, often closely related to outcomes. There is evidence, for example, that certain drinking settings are associated with an increased risk of violence (Homel, Carvolth, Hauritz, McIlwain, & Teague, 2004; Quigley, Leonard, & Collins, 2003). As a result, the drinking environment is a useful focus of harm reduction measures, especially those linked to concerns about safety and violence (International Center for Alcohol Policies, 2002; Wallin, Norstrom, & Andreasson, 2003; see MODULE 7: Drinking and Violence and MODULE 14: Public Order and Drinking Environments). Particularly in some developing countries, traditional establishments, such as shebeens or bodegas, are venues where traditional beverages are sold and consumed. Ensuring the quality of such beverages is an important aspect of minimizing the potential harm for patrons (Haworth & Simpson, 2004).

Responsible hospitality measures have been useful in creating safe and comfortable drinking venues (Homel et al., 2004; Quigley et al., 2003). The objective of such measures is to ensure that risk for any harm to individuals is minimized, while at the same time safeguarding the quality of life in the surrounding community. As a policy approach, responsible hospitality hinges upon the involvement of those who operate serving establishments, those who enforce the existing laws, and the community as a whole (Saltz & Stanghetta, 1997; Smith, Wiggers, Considine, Daly, & Collins, 2001; Stockwell, 2001; Turrisi, Nicholson, & Jaccard, 1999).

Community and drinking context

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Particularly in urban areas around the world, there has been an increase over recent years in late-night entertainment activity, taking place in bars, pubs, and nightclubs. While such venues contribute to the local economy and are a major attraction in most cities, this activity is also the source of many social problems (e.g., Gruenewald et al., 1996; Single, 1997; MODULE 14: Public Order and Drinking Environments ).

Much late night entertainment involves drinking, and much of it is geared towards young adults. Noise, rowdy behavior, littering, and public disorder are not uncommon in some areas, and crime and violence can be an undesirable feature of late-night entertainment (Room, Graham, Rehm, Jernigan, & Monteiro, 2003). In general, these outcomes are linked most closely with heavy drinking patterns, including binge drinking and intoxication (Rossow & Hauge, 2004).

Disorder, crime, and public nuisance place a heavy burden on communities and high demand on public services such as policing, street cleaning, emergency services, and public transportation (Chisholm, Rehm, Van Ommeren, & Monteiro, 2004). Where the density of outlets is high, these issues are of particular concern (Reid, Hughey, & Peterson, 2003; Treno, Grube, & Martin, 2003; Weitzman, Folkman, Folkman, & Wechsler, 2003; Zhu, Gorman, & Horel, 2004). Since access to such areas also requires transportation, alcohol-impaired driving, traffic crashes, and injuries are also subjects for concern (e.g., Wagenaar & Holder, 1991). In countries that have an officially mandated purchase age for alcohol, access to serving outlets by those under that age is another issue in need of attention (see MODULE 12: Legal Age Limits; Freisthler, Gruenewald, Treno, & Lee, 2003; Toomey et al., 1998; Wagenaar et al., 1996).

Over the years, several strategies have evolved to address the potential for harm and its reduction around outlets that serve beverage alcohol (e.g., Single, 1997; Wallin et al., 2003). These strategies include the following:

• policies to control the availability of alcohol through zoning and hours of sale;
• social education efforts to redefine norms on individual behavior (see MODULE 3: Social Norms Marketing );
• incentives for businesses to modify marketing and other practices, often through peer-to-peer influence;
• policies that address the service of alcohol.

Harm reduction around licensed serving establishments

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A range of approaches has been developed targeting the service of alcohol in drinking establishments. Rather than relying on control measures to curtail the availability of alcohol through zoning, hours of sale, and similar measures, these approaches rely on modifications and interventions in a number of areas that can make drinking establishments safer (Daly, Campbell, Wiggers, & Considine, 2002; Graham et al., 2004; Homel et al., 2004; International Center for Alcohol Policies, 2002; Quigley et al., 2003; Single, 1997).

Licensing hours

Where binge and rapid alcohol consumption are part of the local culture, licensing hours can help reduce the potential for harm by preventing heavy drinking and intoxication that often occur around closing time. The “last call” in pubs and bars often translates into patrons ordering several drinks at once and consuming them rapidly before closing. Extending licensing hours has been applied in some places to avoid the closing-time rush and reduce the incidence of intoxication and related antisocial behavior and disorder (Bruce, 1980; Duffy, 1992).

Personnel training

Intoxicated patrons have been identified as a key predictor of harm in and around serving establishments. Continued service to these individuals may lead to violent incidents within the venue, as guests leave establishments during closing time, and may also result in injury from drinking and driving (Toomey et al., 1998). Thus, many service establishments attempt to educate their staff (servers and security personnel) about handling drunk patrons, liability issues, and the importance of server judgment in reducing incidents such as alcohol-impaired driving (Burns, Nusbaumer, & Reiling, 2003; Johnsson & Berglund, 2003; Single, 1990; Sloan, Stout, Whetten-Goldstein, & Liand, 2000; Stockwell, 2001).

Other components that have been usefully coupled with server training include the provision of alternate means of transportation for those who may no longer be fit to drive or incentives for individuals willing to refrain from drinking alcohol and act as “designated drivers” (Dresser & Gliksman, 1998; MODULE 15: Drinking and Driving).

Where minimum legal drinking ages exist, servers and other personnel may also be trained to enforce these laws, requesting identification from patrons and refusing service to underage youths (Freisthler et al., 2003; Toomey et al., 1998; Wagenaar et al., 1996; MODULE 12: Legal Age Limits).

Management and design practices

Effective management can ensure the increased wellbeing of patrons through attention to the following:

• cleanliness and maintenance of premises;
• clearly displayed conditions of entry, codes of dress;
• adequate quality of ventilation;
• sufficient but subtle lighting and moderate noise level;
• availability of seating;
• crowd control and adequate security measures and personnel;
• limiting size of individual parties;
• ensuring a mix of patrons by age and gender (for example, discouraging all-female “hen” and all-male “stag” parties);
• discouraging intoxicated patrons;
• availability of food and nonalcoholic beverage choices;
• limiting specials, such as “happy hours,” “two-fers,” and novelty events.

There is evidence that addressing any of these elements can reduce the likelihood of undesirable incidents and adverse outcomes (e.g., Arnold & Laidler, 1994; The Portman Group, 2000).

In some instances, the above measures have been accompanied by widespread public education campaigns to raise awareness among potential patrons of strategies that have been implemented and about lower tolerance for intoxicated behavior.

Product quality

Ensuring that the products served in drinking establishments are of good quality and do not contain toxic substances or contaminants is also an important part of responsible hospitality. Particularly in the developing countries, the beverage alcohol consumed is likely to be traditional (noncommercial), especially among the poorer segments of society for whom commercial beverages are often unaffordable ( MODULE 21: Noncommercial Alcohol ; Haworth & Simpson, 2004). As these traditional and often home-produced beverages are not subject to rigorous quality controls, ensuring their purity and safety is largely the responsibility of those who run establishments where noncommercial alcohol is served (such as shebeens and bodegas).

Safety concerns

A key concern around licensed premises is that of personal safety, especially from aggression and violence. Many of the elements cited above (noise and lighting level, crowding) can significantly reduce the potential for aggressive behavior (MODULE 7: Drinking and Violence; Graham & Homel, 1997; International Center for Alcohol Policies, 2002; The Portman Group, 2000).

However, several other approaches have also proven to be effective in minimizing harm. For instance:

• removal of potentially harmful objects, such as broken glass;
• replacing conventional glass with more durable safety glass;
• substituting plastic for glass containers;
• “smart” beermats and coasters with advice for ensuring safety, particularly for women;
• specially designed beermats that can be used to test drinks for drugs;
• encouraging entertainment such as live music, games, and dancing;
• staggered closing times in areas of high concentrations of serving establishments;
• limiting the number of guests in an establishment.

Implications for policy and prevention

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The desire to provide venues for socializing must be balanced against the need to ensure a safe environment, clean streets, and low rates of crime and public disturbance. This balance of commercial and social freedoms on the one hand, and safety and wellbeing on the other, presents a challenge to policy-makers.

In developing policy measures, it is essential that the sale and consumption of alcohol are not seen in isolation but as part of broader policy, cultural, and social contexts. In addition, any regulation needs to be framed in social rather than economic terms.

Effective licensing laws do not unduly restrict the freedom of adults to socialize with alcohol beverages and are flexible enough to respond to any changes in the social conditions and local requirements. Laws that are easy to understand and implement are needed, as is their effective enforcement (Wiggers et al., 2004). One approach is to make responsible hospitality an integral part of service and a requirement for licensing.

Partnerships between the various stakeholders involved in the service of alcohol have shown considerable promise: Community intervention programs or “accords” have been tested in a number of countries (Crime Prevention Unit, Department of the Prime Minister and Cabinet, Alcohol Advisory Council of New Zealand, & New Zealand Police, 2000; Felson, Berends, Richardson, & Veno, 1997; New South Wales Department of Gaming and Racing, 2004; Wallin et al., 2003; see MODULE 14: Public Order and Drinking Environments ).

These policy approaches generally rely on two components: modifying the environment (as discussed above) and educating the stakeholders. The process involves several elements (Gehan, Toomey, Jones-Webb, Rothstein, & Wagenaar, 1999; Peters, 1988; Single, 1990; Toomey et al., 1998):

• achieving a general agreement on simple and easy to understand rules and codes of practice for serving establishments and their patrons;
• providing businesses with financial incentives for compliance with codes, such as making licensing contingent upon good practice;
• encouraging responsibility among retailers, managers, and servers in establishment by educating them on social and community issues;
• implementing server intervention and training, even as a requirement for licensing;
• forming alliances with policing and enforcement authorities where intervention is needed;
• providing adequate public transportation and accessibility;
• encouraging dialogue with the community and responsiveness to its needs;
• avoiding the imposition of undue restrictions on the availability of alcohol;
• recognizing the role of alcohol in entertainment and within social settings and acknowledging the need to address it within a larger policy context.

Conclusions

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Responsible hospitality measures can best be implemented if all key stakeholders are consulted and included in harm reduction efforts. Alcohol harm reduction should be seen within a broader social context, addressing the issue of serving outlets as it relates to the community as a whole.

From increased sales to commercial freedoms and reduced liability, there are clear benefits to servers and establishment owners from responsible practices. There are also advantages in increased safety not only within and around establishments, but generally in urban areas where these venues are located.

A number of effective harm reduction approaches have been implemented in countries around the world to ensure the safety of establishments where alcohol is served. These include measures directed at the managers and servers. However, the effectiveness of targeted interventions is also contingent upon partnerships and the inclusion of all relevant stakeholders. Thus, partnerships in policy implementation at the community level may need to include individuals working in prevention, licensed premise owners, managers and staff, suppliers, urban planners, residents, and regulatory and enforcement officials.

References

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Arnold, M. J., & Laidler, T. J. (1994). Alcohol misuse and violence: Situational and environmental factors in alcohol-related violence. Canberra, Australia: Common Wealth of Australia.

Bruce, D. (1980). Changes in Scottish drinking habits and behaviour following the extension of permitted evening opening hours. Health Bulletin, 38, 133–137.

Burns, E. D., Nusbaumer, M. R., & Reiling, D. M. (2003). Think they're drunk? Alcohol servers and the identification of intoxication. Journal of Drug Education, 33, 177–186.

Chisholm, D., Rehm, J., Van Ommeren, M., & Monteiro, M. (2004). Reducing the global burden of hazardous alcohol use: A comparative cost-effectiveness study. Journal of Studies on Alcohol, 65, 782–793.

Crime Prevention Unit, Department of the Prime Minister and Cabinet, Alcohol Advisory Council of New Zealand (ALAC), & New Zealand Police. (2000). Alcohol accords: Getting results. A practical guide for accord partners. Retrieved March 4, 2005, from http://www.ndp.govt.nz/alcohol/alcoholaccords-gettingresults.pdf .

Daly, J. B., Campbell, E. M., Wiggers, J. H., & Considine, R. J. (2002). Prevalence of responsible hospitality policies in licensed premises that are associated with alcohol-related harm. Drug and Alcohol Review, 21, 113–120.

Dresser, J., & Gliksman, L. (1998). Comparing statewide alcohol server training systems. Pharmacology, Biochemistry and Behavior, 61, 150.

Duffy, J. C. (1992). Scottish licensing reforms. In M. A. Plant, E. B. Ritson & R. J. Robertson (Eds.), Alcohol and drugs: The Scottish experience. Edinburgh, United Kingdom: Edinburgh University Press.

Felson, M., Berends, R., Richardson, B., & Veno, A. (1997). Reducing pub hopping and related crime. In R. Homel (Ed.), Policing for prevention: Reducing crime, public intoxication, and injury (pp. 115–132). Crime Prevention Studies, No. 7. Monsey, NY: Criminal Justice Press.

Freisthler, B., Gruenewald, P. J., Treno, A. J., & Lee, J. (2003). Evaluating alcohol access and the alcohol environment in neighborhood areas. Alcoholism: Clinical and Experimental Research, 27, 477–484.

Gehan, J. P., Toomey, R. L., Jones-Webb, R., Rothstein, C., & Wagenaar, A. C. (1999). Alcohol outlet workers and mangers: Focus groups on responsible service practices. Journal of Alcohol and Drug Education, 44, 60–71.

Graham, K., & Homel, R. (1997). Creating safer bars. In M. Plant, E. Single & T. Stockwell (Eds.), Alcohol: Minimising the harm. What works? (pp. 171–192). New York: Free Association Books.

Graham, K., Osgood, D. W., Zibrowski, E., Purcell, J., Gliksman, L., Leonard, K., et al. (2004). The effect of the Safer Bars programme on physical aggression in bars: results of a randomized controlled trial. Drug and Alcohol Review, 23, 31–41.

Gruenewald, P. J., Millar, A. B., Treno, A. J., Yang, Z., Ponicki, W. R., & Roeper, P. (1996). The geography of availability and driving after drinking. Addiction, 91, 967–983.

Haworth, A., & Simpson, R. (Eds.). (2004). Moonshine markets: Issues in unrecorded alcohol beverage production and consumption. New York: Brunner-Routledge.

Heath, D. B. (2000). Drinking occasions: Comparative perspectives on alcohol and culture. Philadelphia, PA: Brunner/Mazel.

Homel, R., Carvolth, R., Hauritz, M., McIlwain, G., & Teague, R. (2004). Making licensed venues safer for patrons: What environmental factors should be the focus of interventions? Drug and Alcohol Review, 23, 19–29.

International Center for Alcohol Policies. (2002). Violence and licensed premises. Washington, DC: Author.

Johnsson, K. O., & Berglund, M. (2003). Education of key personnel in student pubs leads to a decrease in alcohol consumption among the patrons: A randomized controlled trial. Addiction, 98, 627–633.

New South Wales Department of Gaming and Racing. (2004). Liquor accords: Local solutions for local problems. Sydney, Australia: Author.

Oldenburg, R. (1999). The great good place: Cafes, coffee shops, bookstores, bars, hair salons, and other hangouts at the heart of a community. New York: Marlowe & Company.

Peters, J. E. (1988, July–August). Responsible hospitality. Paper presented at the 35th International Congress on Alcoholism and Drug Dependence (ICAA), Oslo, Norway.

Quigley, B. M., Leonard, K. E., & Collins, R. L. (2003). Characteristics of violent bars and bar patrons. Journal of Studies on Alcohol, 64, 765–772.

Reid, R. J., Hughey, J., & Peterson, N. A. (2003). Generalizing the alcohol outlet-assaultive violence link: Evidence from a U.S. Midwestern city. Substance Use and Misuse, 38, 1971–1982.

Room, R., Graham, K., Rehm, J., Jernigan, D., & Monteiro, M. (2003). Drinking and its burden in a global perspective: Policy considerations and options. European Addiction Research, 9, 165–175.

Rossow, I., & Hauge, R. (2004). Who pays for the drinking? Characteristics of the extent and distribution of social harms from others' drinking. Addiction, 99, 1094–1102.

Saltz, R. F., & Stanghetta, P. (1997). A community-wide responsible beverage service program in three communities: Early findings. Addiction, 92(Suppl. 2), S237–S249.

Single, E. (1990). Paths ahead for server interventions in Canada. Rockville, MD: Office for Substance Abuse Prevention, U.S. Department of Health and Human Services.

Single, E. (1997). Public drinking, problems and prevention measures in twelve countries: Results of the WHO project on public drinking. Contemporary Drug Problems, 24, 425–448.

Sloan, F. A., Stout, E. M., Whetten-Goldstein, K., & Liand, L. (2000). Drinkers, drivers, and bartenders. Balancing private choices and public accountability. Chicago, IL: University of Chicago Press.

Smith, K. L., Wiggers, J. H., Considine, R. J., Daly, J. B., & Collins, T. (2001). Police knowledge and attitudes regarding crime, the responsible service of alcohol and a proactive alcohol policing strategy. Drug and Alcohol Review, 20, 181–191.

Stockwell, T. (2001). Responsible alcohol service: Lessons from evaluations of servers training and policing initiatives. Drug and Alcohol Review, 20, 257–265.

The Portman Group. (2000). Keeping the peace: A guide to the prevention of alcohol-related disorder. Retrieved April 5, 2005, from http://www.portman-group.org.uk/uploaded_files/documents/35_49_KeepingthePeace.pdf .

Toomey, T. L., Kilian, G. R., Gehan, J. P., Perry, C. L., Jones-Webb, R., & Wagenaar, A. C. (1998). Qualitative assessment of training programs for alcohol servers and establishment managers. Public Health Reports, 113, 162–169.

Treno, A. J., Grube, J. W., & Martin, S. E. (2003). Alcohol availability as a predictor of youth drinking and driving: A hierarchical analysis of survey and archival data. Alcoholism: Clinical and Experimental Research, 27, 835–840.

Turrisi, R., Nicholson, B., & Jaccard, J. (1999). A cognitive analysis of server intervention policies: Perceptions of bar owners and servers. Journal of Studies on Alcohol, 60, 37–46.

Wagenaar, A. C., & Holder, H. D. (1991). Effects of alcoholic beverage server liability on traffic crash injuries. Alcoholism: Clinical and Experimental Research, 15, 942–947.

Wagenaar, A. C., Toomey, T. L., Murray, D. M., Short, B. J., Wolfson, M., & Jones-Webb, R. (1996). Sources of alcohol for underage drinkers. Journal of Studies on Alcohol, 57, 325–333.

Wallin, E., Norstrom, T., & Andreasson, S. (2003). Alcohol prevention targeting licensed premises: A study of effects on violence. Journal of Studies on Alcohol, 64, 270–277.

Weitzman, E. R., Folkman, A., Folkman, M. P., & Wechsler, H. (2003). The relationship of alcohol outlet density to heavy and frequent drinking and drinking-related problems among college students at eight universities. Health Place, 9, 1–6.

Wiggers, J., Jauncey, M., Considine, R., Daly, J., Kingsland, M., Purss, K., et al. (2004). Strategies and outcomes in translating alcohol harm reduction research into practice: the Alcohol Linking Program. Drug and Alcohol Review, 23, 355–364.

Zhu, L., Gorman, D. M., & Horel, S. (2004). Alcohol outlet density and violence: A geospatial analysis. Alcohol and Alcoholism, 39, 369–375.