Does legislation to prevent alcohol sales to drunk individuals work? Measuring the propensity for night-time sales to drunks in a UK city

Abstract

BackgroundBy measuring alcohol retailers’ propensity to illegally sell alcohol to young people who appear highly intoxicated, we examine whether UK legislation is effective at preventing health harms resulting from drunk individuals continuing to access alcohol.Methods73 randomly selected pubs, bars and nightclubs in a city in North West England were subjected to an alcohol purchase test by pseudo-drunk actors. Observers recorded venue characteristics to identify poorly managed and problematic (PMP) bars.Results83.6% of purchase attempts resulted in a sale of alcohol to a pseudo-intoxicated actor. Alcohol sales increased with the number of PMP markers bars had, yet even in those with no markers, 66.7% of purchase attempts resulted in a sale. Bar servers often recognised signs of drunkenness in actors, but still served them. In 18% of alcohol sales, servers attempted to up-sell by suggesting actors purchase double rather than single vodkas.ConclusionsUK law preventing sales of alcohol to drunks is routinely broken in nightlife environments, yet prosecutions are rare. Nightlife drunkenness places enormous burdens on health and health services. Preventing alcohol sales to drunks should be a public health priority, while policy failures on issues, such as alcohol pricing, are revisited.

Factors associated with over‐serving at drinking establishments

“…Our observation of a higher service rate later at night is consistent with previous observations [17,20,43], as was the increased likelihood of over-serving with greater intoxication level of other patrons [17,43,44] and with high music (or noise) level [18]. Consistent with Hughes et al [18], we found that over-serving was associated with a sum-score of indicators of problematic bars.…”

“…Most previous studies have used male actors [30] or they did not address gender differences or report the gender of the actors, whereas two studies found no significant association between patron gender and over-serving [45,46]. Similarly, an Australian study [47] found no statistically significant gender difference in survey respondents' reports of servers intervening when the respondents showed signs of intoxication at drinking establishments.…”

“…The last three variables corresponded to some of those previously used by Hughes et al [18] and were included in a sum-score of problematic bar indicators (PBI, range 0-6). This variable was truncated into low (0-1), medium (2-3), and high (4-6) score and in multi-variate analyses used as a dichotomous measure; low/medium score (0-3) vs. high score (4-6).…”

“…Despite widespread implementation, these programmes are mostly ineffective at preventing alcohol sales to intoxicated patrons [7][8][9] Thus, despite prohibition and server training programmes, customers who are clearly intoxicated are likely to be served [2,[10][11][12][13][14][15][16][17][18]. In the following, we refer to this as over-serving.…”

“…Recently, Hughes and her colleagues [18] found that the rate of over-serving increased in a linear fashion with a composite measure of poorly managed and problematic bars that included indicators such as the age of the bar staff, cleanliness of the bar, crowdedness, noise level, and age and drunkenness of the customers. Although many studies have found that these factors are associated with violence and disorderly behaviour in bars [21][22][23], few studies have found them to be associated with over-serving.…”