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- Where people drink is an important component of drinking patterns and is closely related to outcomes, both positive and negative.
- Ensuring that the drinking environment is safe and conducive to enjoyment and positive social interaction is a useful approach to targeted interventions.
- Effective strategies around responsible hospitality include a mix of regulation, enforcement, education, and incentives.
- Harm reduction measures directed at responsible hospitality include server training, as well as modifications to the drinking environment.
- In order to ensure that the environment in and around serving establishments remains safe, partnerships are needed, involving the local community, those responsible for selling and serving alcohol, and enforcing alcohol-related regulations. These partnerships should be cognizant of local needs and resources.
- For examples of interventions, see the online database Initiatives Reporting: Industry Actions to Reduce Harmful Drinking.
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).
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).
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.
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).
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.
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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.
POLICY OPTIONS: Responsible Hospitality
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In developing policies and approaches, consideration of a number of key elements is required. While some may be necessary at a minimum and under most conditions, others may not be appropriate in all cases, or may be difficult to implement. The list below offers a menu of areas that need to be addressed, based on effective approaches that have been implemented elsewhere. Specific examples are provided in the Examples of Targeted Interventions section of the ICAP Blue Book.
Responsible hospitality initiatives may be voluntary or mandated.
- Initiatives implemented through serving outlets, as well as alcohol producers, distributors, and retailers.
- Initiatives implemented at community level through individual jurisdictions.
- Initiatives as a requirement for licensing.
Rely on partnership and coordination between serving establishments, law enforcement, transport, community, other retail, urban planners, etc. Approaches may include:
- Codes of practice.
- Incentives for compliance, such as making licensing contingent upon initiatives.
- Alliance with policing and law enforcement.
- Access to adequate public transportation.
Management and design
- Maintenance of premises, crowd control, availability of seating, limiting party size.
- Encourage diversity among patrons, discourage intoxication.
- Availability of food and nonalcoholic beverage choices.
- Limiting specials and novelty events.
Training of (serving and security) personnel about:
- Preventing drunk patrons and handling those who are already intoxicated.
- Liability issues related to proof of age and alcohol-impaired driving.
- Attention to “last call” policies.
- Staggered closing times.
- Responsiveness to community concerns around violence and public disturbance.
Designated driver programs or alternative transportation options.
- Use of durable safety glass, plastic containers, beermats with advice and safety tips (e.g., for women).
- Encourage entertainment and enforce crowd control.
Product quality (particularly where noncommercial alcohol is served):
- Ensuring purchase from reputable producers.
- Use of clean and non-toxic containers and vessels.
- Incentives to producers to sell quality products.
- Product testing implemented with commercial producers (to discourage counterfeit).
Involvement of law enforcement to monitor quality.
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