Drunk and disorganised: relationships between bar characteristics and customer intoxication in European drinking environments.

Preventing alcohol-related harm in drinking environments is a growing international priority. Factors relating to the physical, social and staffing environments in bars can contribute to increased alcohol consumption and harm. Understanding the relationships between such factors and intoxication in European drinking environments is critical to developing appropriate interventions. We undertook a quantitative observational study in 60 bars in four European cities, in The Netherlands, Slovenia, Spain and the UK (n = 237 observational visits). Using a structured observational schedule, researchers recorded characteristics of the bar environment and rated customer intoxication levels. All physical bar characteristics showed associations with intoxication before interactions between them were controlled for. Hierarchical modelling found significant independent associations between intoxication and use of plastic glassware, promotion of non-alcoholic drinks (often energy drinks), permissive environments, poor washroom facilities, the presence of a dance floor, customer sexual activity/competitiveness and later observational time. Findings suggest that prevention efforts should focus on raising and enforcing managerial standards in bars. While harm reduction measures such as plastic glassware are often promoted for high risk bars, such measures are inadequate to address public health concerns and insufficient to demonstrate social responsibility.

Drinking behaviours and blood alcohol concentration in four European drinking environments: a cross-sectional study.

BACKGROUND: Reducing harm in drinking environments is a growing priority for European alcohol policy yet few studies have explored nightlife drinking behaviours. This study examines alcohol consumption and blood alcohol concentration (BAC) in drinking environments in four European cities. METHODS: A short questionnaire was implemented among 838 drinkers aged 16-35 in drinking environments in four European cities, in the Netherlands, Slovenia, Spain and the UK. Questions included self-reported alcohol use before interview and expected consumption over the remainder of the night. Breathalyser tests were used to measured breath alcohol concentration (converted to BAC) at interview. RESULTS: Most participants in the Dutch (56.2%), Spanish (59.6%) and British (61.4%) samples had preloaded (cf Slovenia 34.8%). In those drinking < 3 h at interview, there were no differences in BAC by gender or nationality. In UK participants, BAC increased significantly in those who had been drinking longer, reaching 0.13% (median) in females and 0.17% in males drinking > 5 h. In other nationalities, BAC increases were less pronounced or absent. High BAC (> 0.08%) was associated with being male, aged > 19, British and having consumed spirits. In all cities most participants intended to drink enough alcohol to constitute binge drinking. CONCLUSIONS: Different models of drinking behaviour are seen in different nightlife settings. Here, the UK sample was typified by continued increases in inebriation compared with steady, more moderate intoxication elsewhere. With the former being associated with higher health risks, European alcohol policy must work to deter this form of nightlife.

Alcohol and drug prevention in nightlife settings: a review of experimental studies.

This study examines the evidence regarding the effectiveness of interventions aimed at the prevention of harmful alcohol and drug use in nightlife settings. A literature search was conducted in 2009. Of 161 studies, 17 experimental studies were included in the review, 15 alcohol-related and two drug-related studies. The results show that preventive substance abuse interventions in nightlife settings can effectively reduce high-risk alcohol consumption, alcohol-related injury, violent crimes, access to alcohol by underage youth, and alcohol service to intoxicated people. A combination of approaches such as enforcement activities seem to be facilitating factors. However, results should be considered cautiously as more gold standard (cost-) effectiveness research is required, in particular directed at drug prevention and educational interventions in nightlife settings.

Environmental factors in drinking venues and alcohol-related harm: the evidence base for European intervention.

AIMS: Reducing alcohol-related harm in young people is a major priority across Europe. Much alcohol use and associated harm in young people occurs in public drinking environments. This review aims to identity environmental factors in drinking establishements that are associated with increased alcohol consumption and associated harm and to understand the extent of study in this area across Europe. METHODS: A systematic literature search identified studies that had explored associations between physical, staffing and social factors in drinking environments and increased alcohol use or alcohol-related harm. RESULTS: Fifty-three papers were identified, covering 34 studies implemented in nine countries. Most studies had been implemented in non-European countries and many had collected data more than a decade prior to the review. The majority had used observational research techniques. Throughout the studies, a wide range of physical, staffing and social factors had been associated with higher levels of alcohol use and related harm in drinking environments. Factors that appeared particularly important in contributing to alcohol-related problems included a permissive environment, cheap alcohol availability, poor cleanliness, crowding, loud music, a focus on dancing and poor staff practice. However, findings were not always consistent across studies. CONCLUSIONS: Drinking establishments, their management and the behaviours of the young people who use them vary widely across Europe. While international research shows that environmental factors in drinking settings can have an important influence on alcohol-related harm, there is currently a scarcity of knowledge on the relevance and impacts of such factors in modern European settings. Developing this knowledge will support the implementation of strategies to create drinking environments in Europe that are less conducive to risky drinking and alcohol-related harm.

Avoiding counterproductive results: an experimental pretest of a harm reduction intervention on attitude toward party drugs among users and nonusers.

In two experimental studies, the authors tested written health education materials on the personal acceptance of party drug use. Following a harm reduction strategy, the materials provided information on minimizing potential hazards associated with drug use. Among users and nonusers, potential aversive effects of these materials were examined on measures of attitude, intention, and outcome expectancy toward party drug use. Participants were recruited in the city center of Maastricht, The Netherlands, in nightlife settings that were popular among young people. In the first experiment, a leaflet on ecstasy use was evaluated among ecstasy users and nonusers. Results showed neither health promoting effects, nor counterproductive results on the outcome measures. In the second experiment, the effects of two different formats (leaflet vs. infocard) about two different kinds of party drugs (ecstasy vs. GHB) were compared within a nonusing population. Again, results showed no positive changes on the outcome measures toward ecstasy use as a result of exposure to the ecstasy materials. However, exposure to the GHB materials resulted into a more negative attitude toward GHB use (leaflet and infocard) and lower estimates of the likelihood of positive outcomes of use (infocard). The study's limitations and implications are discussed, including the need for experimental pretesting.