Responsible Beverage Service Research Articles

Long-term effects of an alcohol prevention program at licensed premises: a Swedish 20-year follow-up study.

In 1996, a multicomponent community-based alcohol prevention program in Responsible Beverage Service (RBS) targeting licensed premises was developed by STAD (Stockholm Prevents Alcohol and Drug Problems) and implemented in Stockholm, Sweden. The program consists of community mobilization and collaboration, training, and enforcement. Early evaluations have shown a significant increase in the refusal rates of alcohol service to intoxicated patrons, from 5% in 1996 to 70% in 2001, and a 29% decrease in the frequency of police-reported violence. A cost-effectiveness analysis showed a cost-saving ratio of 1:39. The program was institutionalized by a collaborative steering group consisting of community stakeholders. This study aimed to evaluate the long-term effects over 20 years of the RBS program. The indicator chosen was the rate of alcohol overserving to obviously intoxicated patrons at licensed premises in Stockholm. A 20-year follow-up study was conducted using the same procedure as the baseline and previous follow-ups. Professional male actors (pseudopatrons) were trained by an expert panel to enact a standardized scene of obvious alcohol-intoxication. In 2016, 146 licensed premises located in the central part of Stockholm were randomly selected and visited. A review of program implementation from its initiation 1996 was conducted, examining critical events, including commitment from key actors in the community, training of bar staff, and enforcement. At the 20-year follow-up, pseudopatrons were refused alcohol service in 76.7% of the attempts, which was at the same level (70%) as in the follow-up in 2001, thus indicating sustained effects of the RBS program. Compared with previous follow-ups, serving staff used more active intervention techniques in 2016 toward intoxicated patrons, such as refusing to take the order (56.9% in 2016 vs. 42.0% in 2001), and fewer passive techniques, such as ignoring patrons (6.5% in 2016 vs. 15.5% in 1999) or contacting a colleague (4.1% in 2016 vs. 25% in 2001). The sustained long-term effects of the RBS program are unique and can be explained by the high level of institutionalization of the multicomponent program, which is still ongoing in Stockholm. These findings can inform the dissemination of the program to other countries and settings.

The Effectiveness of Responsible Beverage Service Training Programs: A Literature Review and Synthesis

Studies have revealed that approximately half of driving while intoxicated (DWI) offenders had their last alcoholic drink at a licensed bar or restaurant. Sales and service of alcohol to underage youth and those already intoxicated contributes to many causes of injuries.

Serving Alcohol to an "Obviously Intoxicated" Patron.

Alcohol overservice at on-premises establishments is associated with driving while intoxicated, violence, and other harms. This study examined rates of alcohol overservice and service refusal among licensed on-premises establishments in northern California and characteristics of establishments, servers, and pseudo-patrons (PPs) that may be associated with service refusal. In 2022, 300 licensed on-premises establishments were sampled in nine counties representing the San Francisco Bay Area. From July 2022 to January 2023, PP and observer teams visited each establishment, and PPs attempted to buy alcohol while displaying obvious signs of intoxication. The outcome of each purchase attempt; characteristics of establishments, servers, and PPs; and month, day, and time were recorded. Descriptive and regression analyses were conducted to address study objectives. Twenty-one percent of the establishments refused alcohol service to PPs. No establishment or server characteristics were significantly associated with service refusal in logistic regression analysis, nor were month, day, or time. However, service refusal was significantly more likely among female PPs (odds ratio = 3.71, 95% CI [1.67, 8.24], p < .01) and PPs displaying obvious or very obvious signs of intoxication (odds ratio = 9.28, 95% CI [1.99, 43.40], p < .01). There was no significant interaction effect of PP × Server Gender on the likelihood of service refusal. This study indicates that alcohol overservice to obviously intoxicated patrons remains common at licensed on-premises establishments. Mandatory responsible beverage service training of servers and enforcement of alcohol overservice laws are needed to reduce overservice and related harms.

Professional Development to Improve Responsible Beverage Service Training: Formative Research Results and Protocol for a Randomized Controlled Trial.

Improved interventions are needed to reduce the rate of driving while intoxicated. Responsible beverage service (RBS) training has reduced service to intoxicated patrons in licensed premises in several studies. Its efficacy might be improved by increasing the proper application and continued use of RBS with a professional development program in the 3 to 5 years between the required RBS retraining. This study aims to develop and evaluate a professional development component for an RBS training that aims to improve the effectiveness of the web-based training alone. In a 2-phase project, we are creating a professional development component for alcohol servers after completing an RBS training. The first phase involved formative research on the feasibility, acceptability, and potential effectiveness of components. Semistructured interviews with owners and managers of licensed establishments and focus groups and a survey with alcohol servers in New Mexico and Washington State examined support for RBS and the need for ongoing professional development to support RBS. A prototype of a professional development component, WayToServe Plus, was produced for delivery in social media posts on advanced RBS skills, support from experienced servers, professionalism, and basic management training. The prototype was evaluated in a usability survey and a field pilot study with alcohol servers in California, New Mexico, and Washington State. The second phase of the project will include full production of the professional development component. It will be delivered in Facebook private groups over 12 months and evaluated with a sample of licensed premises (ie, bars and restaurants) in California, New Mexico, and Washington State (n=180) in a 2-group randomized field trial (WayToServe training only vs WayToServe training and WayToServe Plus). Licensed establishments will be assessed for refusal of sales to apparently intoxicated pseudopatrons at baseline and 12 months after the intervention commences. Although owners and managers (n=10) and alcohol servers (n=43) were favorable toward RBS, they endorsed the need for ongoing support for RBS for servers and identified topics of interest. A prototype with 50 posts was successfully created. Servers felt that it was highly usable and appropriate for themselves and the premises in the usability survey (n=20) and field pilot test (n=110), with 85% (17/20) and 78% (46/59), respectively, saying they would use it. Servers receiving the professional development component had higher self-efficacy (d=0.30) and response efficacy (d=0.38) for RBS compared with untreated controls. Owners, managers, and servers believed that an ongoing professional development component on RBS would benefit servers and licensed premises. Servers were interested in using such a program, a large majority engaged with the prototype, and servers receiving it improved on theoretic mediators of RBS. Thus, the professional development component may improve RBS training. ClinicalTrials.gov NCT05779774; http://tinyurl.com/4mw6d2vk. DERR1-10.2196/49680.

Sales to Apparently Intoxicated Customers in Three States With Different Histories of Responsible Beverage Service Training.

Most states prohibit sales of alcohol to customers who are apparently intoxicated, and many require training in responsible beverage service (RBS), with the aim of reducing driving while intoxicated (DWI) and other harms. Sales to apparently intoxicated patrons were assessed in onsite alcohol sales establishments and compared across three states. A sample of 180 licensed onsite alcohol establishments was selected in California (n = 60), New Mexico (n = 60), and Washington State (n = 60). States had different RBS training histories, content, and procedures. Research confederates, trained to feign cues of intoxication, visited each establishment twice. The pseudo-intoxicated patron (PP) ordered an alcoholic beverage while displaying intoxication cues. Sale of alcohol was the primary outcome. At 179 establishments assessed, PPs were served alcohol during 56.5% of 356 visits (35.6% of establishments served and 22.6% did not serve at both visits). Alcohol sales were less frequent in New Mexico (47.9% of visits; odds ratio [OR] = 0.374, p = .008) and Washington State (49.6%; OR = 0.387, p = .012) than in California (72.0%). Servers less consistently refused service at both visits (6.8%) in California than New Mexico (33.9%) or Washington (27.1%), χ2(4, n = 177) = 16.72, p = .002. Alcohol sales were higher when intoxication cues were less obvious (p < .001). Overservice of alcohol to apparently intoxicated customers was frequent and likely elevated risk of DWI and other harms. The lower sales in New Mexico and Washington than California may show that a policy approach prohibiting sales to intoxicated customers combined with well-established RBS training can reduce overservice. Further efforts are needed to reduce overservice.

Illicit Drugs in the Nightlife Setting: Changes in Employee Perceptions and Drug Use over a Fifteen-Year Period

Background Illicit drug use is common in nightlife settings and associated with various public health-related problems, making this an important arena for prevention. Purpose/objectives: To assess perceived prevalence of illicit drug use in the Stockholm nightlife setting, use of and attitudes toward illicit drugs among employees at licensed premises. Also, to make comparisons with two identical measurements from 2001 and 2007/08, and to explore potential differences related to own drug use, type of licensed premise, age or gender. Methods: Cross-sectional surveys were conducted at three time-points: 2001, 2007/08, and 2016/17, comprising employees at licensed premises in Stockholm participating in STAD’s Responsible Beverage Service training program. A total of 665 persons (mean age 28 years, 53% women) were included in the 2016/2017 measurement. Results: A majority of the respondents reported having observed patrons intoxicated by illicit drugs in the last six months, and agreed that patrons intoxicated by illicit drugs should be asked to leave licensed premises. The belief that one had observed patrons intoxicated by illicit drugs was more common among respondents who had themselves been using illicit drugs during the last year, and also among employees at nightclubs. Furthermore, comparisons with previous time-points showed a significant increase in the proportion of employees using illicit drugs. Almost half of the respondents in the youngest age group (18–24 years) reported illicit drug use during the last year. Conclusions/importance: Observation and use of illicit drugs are common among employees in the Stockholm nightlife setting and has increased significantly during the past decade.

Alcohol Availability, Use, and Harms Among Adolescents in Three Mexican Cities.

Alcohol remains readily available to youth in most countries. We examined the associations between both the on- and off-premises commercial availability of alcohol to youth and their alcohol use, heavy episodic drinking, and alcohol-related harms. We conducted the study using data from a survey of a sample of 594 students in central Mexico between 12 and 17 years of age in 2016. Both the perceived availability of alcohol and the purchasing of alcohol at an off-premises establishment were positively related to past-30-day alcohol use and heavy episodic drinking, as well as to alcohol-related harms in the past year. Consumption at on-premises establishments was also positively associated with alcohol-related harms. Preventive efforts to reduce the availability of alcohol at off- and on-premises establishments, by such strategies as mystery shopper and responsible beverage service programs, are imperative.

Night-time is the right time? Late-night drinking and assaults in Finnish public and private settings.

The risk of alcohol-related injuries and violence increases in late-night settings. We analysed temporal patterns of drinking and assaults and present an event-level analysis of connections between night-time drinking, estimated blood alcohol level, location and drinkers' age and sex. Main data source is a Finnish general population (aged 18-69 years) survey carried out in 2016 (n = 1962), including event-level data on drinking occasions in the previous 7 days (n = 1891). Statistical analyses consisted of tabulations and logistic regression analyses. Finns' drinking peaked around 8-9 pm on most days, with the greatest peaks on Fridays and Saturdays. The main pattern was similar for drinking occasions occurring in home surroundings and in licensed premises, but a larger proportion of the latter occurred in later hours of the day. Assaults had a similar weekday distribution, but the peak occurred several hours later, around 3-5 am. One explanation is that the mean estimated blood alcohol concentration strongly increased as the ending time of the drinking occasion extended later into the night, and the proportion of late-night drinking was higher in licensed premises than home surroundings. Peaks for assaults in public places temporally coincide with the late closing times of licensed premises and with high estimated blood alcohol concentrations among drinkers. The results underline a need to reduce harm from intoxication, which in public places could include restricted opening hours, increased law enforcement, improved responsible beverage service practices and other interventions to better manage aggression.

Implementation of Responsible Beverage Service (RBS) of Restaurants and Hotels in Nueva Ecija

Implementation of Responsible Beverage Service (RBS) of Restaurants and Hotels in Nueva Ecija

Results of a Randomized Trial of Web-Based Retail Onsite Responsible Beverage Service Training: WayToServe

Research in Responsible Beverage Service (RBS) training indicates that such training can prevent over-service of alcohol and reduce drunk driving. However, reviews of the RBS literature suggest that the quality of training methods and the stability of implementation are important factors in determining RBS training effectiveness. Most RBS classes have been taught live, where the quality of instruction varies across instructors and classes, and the stability of the implementation of an RBS curriculum is variable. Web-based RBS training may carry important advantages by stabilizing instruction and implementation factors. Randomized trial results of a web-based onsite RBS training program (WayToServe® [WTS]) are reported here. It was hypothesized that servers trained by WTS would refuse alcohol service at significantly higher rates compared with Usual and Customary (UC) live training. On-site alcohol-serving establishments in New Mexico communities were randomized to receive WTS training (n = 154) or the Usual and Customary live RBS training (n = 155). Premises were assessed at baseline, immediate post-training, 6-months post-training, and 1-year post-training intervals. Pseudo-intoxicated patron protocols were used to assess premise alcohol service during the early to mid-evening hours of 6:30 P.M. to 8:30 P.M., with the percentage of alcohol service refusals to apparently intoxicated pseudo-patrons as the primary outcome variable. Results indicate significantly higher refusal rates for WTS than for UC premises at the immediate (WTS = 68% vs. UC = 49%) and the 1-year post-training assessment points (WTS = 68% vs. UC = 58%) but not at the 6-month post-training assessment (WTS = 69% vs. UC = 64%). Differences in refusal rates based on pseudo-patron age were observed where younger pseudo-patrons were consistently refused more often than older pseudo-patrons. Effective RBS training can be delivered online, making it a potentially cost-effective way of reaching large alcohol server populations.

Effects of a responsible retailing mystery shop intervention on age verification by servers and clerks in alcohol outlets: A cluster randomised cross-over trial.

Clerks and servers at alcohol establishments often fail to verify age. Using mystery shoppers to provide performance feedback is one approach to improving age verification. Few controlled studies have evaluated mystery shop interventions. This paper reports on a cluster randomised cross-over trial of a mystery shop intervention in 16 communities in four US states. The intervention comprised monthly mystery shops after which clerks and servers received immediate feedback to reinforce age verification. Managers received monthly reports. Communities in each state were matched into pairs and, following a 3-month baseline, were randomly assigned within each pair to receive the intervention beginning after the fourth (Early Intervention) or the tenth (Delayed Intervention) mystery shop. On average, 17 (range = 14-20) randomly selected on-premises and 18 (range = 11-23) off-premises outlets participated in each community (N = 557). Fixed effects multi-level logistic regressions indicated that the intervention led to a two-fold increase in the odds of age verification, odds ratio (OR) = 2.05; P < 0.001; 95% confidence interval (CI) 1.76, 2.39. Overall, ID-checking increased from an average of 80% pre-intervention to 94-96% by the end of the program. Significant effects were found for on-premises, OR = 1.79; P < 0.001; 95% CI 1.43, 2.24, and off-premises establishments, OR = 2.29; P < 0.001; 95% CI 1.86, 2.82. Mystery shop interventions can increase age verification for alcohol purchases and may be an effective supplement to compliance checks and responsible beverage service programs.

Responsible Beverage Service Practices: Comparison between India and Australia

Sale and consumption of alcoholic beverages have been rising globally. This is making the alcohol industry worth over $1344 billion today. This rise in alcohol consumption has not been without its gray shades in the form of alcohol abuse, alcohol-related crimes, accidents and deaths. This paper studies and compares the Responsible Beverage Service practices between India and Australia to understand its scope and impact. The study draws upon review and analysis of research and data from literature and alcohol policies of the two countries. The study reveals the similarities and differences in the approach towards Responsible Beverage Service between these two countries and suggests methods to strengthen this practice in India.

Bartenders' and Rum Shopkeepers' Knowledge of and Attitudes Toward "Problem Drinking" in Saint Vincent and the Grenadines.

Harmful alcohol use encompasses a spectrum of habits, including heavy episodic drinking (HED) which increases the risk of acute alcohol-related harms. The prevalence of HED in Saint Vincent and the Grenadines (SVG) is 5.7% among the overall population aged 15years and older and 10.2% among drinkers. Responsible Beverage Service interventions train alcohol servers to limit levels of intoxication attained by customers and decrease acute alcohol-related harms. The objectives of this study were todetermine bar tenders' and rum shopkeepers' knowledge of and attitudes toward problem drinking and willingness to participate in server training. Researchers used convenience and purposive sampling to recruit 30 participants from Barraouile, Kingstown, and Calliaqua to participate in semi-structured interviews designed to explore study objectives. Results and conclusions were derived from grounded theory analysis. Heavy episodic drinking is common but not stigmatized. Heavy drinking is considered a "problem" if the customer attains a level of disinhibition causing drunken and disruptive or injurious behavior. Bartenders and rum shopkeepers reported intervening with visibly intoxicated patrons and encouraging cessation of continued alcohol consumption. Participants cited economic incentives, prevention of alcohol-related harms, and personal morals as motivators to prevent drunkenness. Respondents acknowledged that encouraging responsible drinking was a legitimate part of their role and were favorable to server training. However, there were mixed opinions about the intervention's perceived efficacy given absent community-wide standards on preventing intoxication and limitations of existing alcohol policy. Given respondents' motivation and lack of standardized alcohol server training in SVG, mandated server training can be an effective strategy when promoted as one piece of a multi-component alcohol policy.

Evaluation of a combination of community initiatives to reduce driving while intoxicated and other alcohol-related harms

ABSTRACTObjectives: In 2013, the community of Redlands, California, created an initiative using evidence-based strategies to deter driving under the influence (DUI), underage drinking and driving, public intoxication, and alcohol-related calls for service. The initiative, called “Responsible Redlands,” included adopting a social host and a deemed approved local ordinance, using minor-decoy and shoulder-tap operations, increasing sobriety checkpoints and saturation patrols, conducting responsible beverage service (RBS) training, using identification (ID) scanners to spot false IDs, and a publicity campaign to urge neighbors to report loud drinking parties. The objectives of this study were to determine whether the initiatives were carried out as planned and to assess any impacts that may have occurred due to the combination of initiatives.Methods: Data from the Redlands Police Department were used to assess the process evaluation. The Statistical Analysis System (SAS) was used to create contingency tables to compare before (2007–2012) and after (2013–2014) the intervention start date and to conduct time-series analyses and calculate chi-squared test statistics on five outcome measures: DUI arrests, underage drinking violations, public intoxication violations, alcohol calls for service, and place of last drink (POLD) data from alcohol violators. Data sources were from the Redlands Police Department: DUI arrests for drivers under age 21 years and drivers age 21 or older; alcohol-related calls for service; public intoxication citations; and place of last drink surveys. Comparable data from control communities in California were not available at the time of the analyses.Results: Responsible Redlands Initiatives appeared to be carried out as planned. There was a statistically significant decrease in DUI arrests for drivers 21 and older from preintervention to postintervention (p < .001), in alcohol-related calls for service (p < .001), in loud music calls for service (p = .06), and in public intoxication citations (p < .001). There were decreases in underage drinking violations and in DUIs for under age 21 drivers, but the numbers were too small for chi-squared statistical tests.Conclusions: “Responsible Redlands” interventions were associated with several significant decreases in outcome measures from preintervention to postintervention. Communities that consider these initiatives in combination (social host and deemed approved ordinances; minor-decoy and shoulder-tap operations; DUI checkpoints and saturation patrols; RBS training; use of ID scanners and a public information campaign to report loud drinking parties) can expect to experience potential decreases in alcohol-related harm.

Overserving and Allowed Entry of Obviously Alcohol-Intoxicated Spectators at Sporting Events.

Alcohol intoxication among spectators at sporting events and related problems, such as violence, are of great concern in many countries around the world. However, knowledge is scarce about whether or not alcohol is served to obviously intoxicated spectators at licensed premises inside and outside the sporting arenas, and if obviously intoxicated spectators are allowed entrance to these events. The objective of this study was therefore to examine the occurrences of overserving at licensed premises inside and outside arenas, and of allowed entry of obviously intoxicated spectators into arenas. An observational study assessing the rate of denied alcohol service and denied entry to arenas of trained professional actors portraying a standardized scene of obvious alcohol intoxication (i.e., pseudo-patrons) was conducted. The scene was developed by an expert panel, and each attempt was monitored by an observer. The settings were 2 arenas hosting matches in the Swedish Premier Football League in the largest city in Sweden and 1 arena in the second largest city, including entrances and licensed premises inside and outside the arenas. The rates of denied alcohol service were 66.9% at licensed premises outside the arenas (n=151) and 24.9% at premises inside the arenas (n=237). The rate of denied entry to the arenas (n=102) was 10.8%. Overserving and allowed entry of obviously alcohol-intoxicated spectators are problematic at sporting events in Sweden and may contribute to high overall intoxication levels among spectators. The differences in server intervention rates indicate that serving staff at licensed premises inside the arenas and entrance staff are not likely to have been trained in responsible beverage service. This result underscores the need for server training among staff at the arenas.

Changes in alcohol policies and practices in bars and restaurants after completion of manager-focused responsible service training.

Irresponsible and illegal serving practices at bars and restaurants, such as sales to obviously intoxicated patrons, can lead to various public health harms. Training managers of bars and restaurants in the development and promotion of responsible alcohol policies may help prevent risky and illegal alcohol serving practices. We implemented a training program for managers of bars/restaurants designed to establish and promote responsible beverage service policies/practices. The program included online and in-person components. Bars/restaurants were randomised to intervention (n = 171) and control (n = 163) groups. To assess changes in policies/practices, we surveyed managers prior to and at 1 and 6 months post-training. Logistic regression models assessed changes in policies/practices across time points. The proportion in the intervention group that had written alcohol policies increased from 62% to 95% by 6 months post-training while the control group increased from 65% to 79% (P < 0.05). Similarly, by 6 months post-training 70% of managers in the intervention group reported they had communicated to their staff how to cut off intoxicated patrons, a significant increase from baseline (37%) and from the change observed in the control group (43%-56%). Prevalence of other policies/practices also increased post-training but differences between intervention and control groups were not statistically significant. Our training program appears to have led to implementation of some policies/practices. Additional studies are needed to determine how training can be combined with other strategies to further improve establishment policies and ultimately reduce alcohol-related harms.

The Spirit Is Willing, But the Flesh is Weak: Why Young People Drink More Than Intended on Weekend Nights-An Event-Level Study.

Heavy alcohol use is common among young adults on weekend nights and is assumed to be intentional. However, little is known about the extent to which heavy consumption is planned prior to the onset of drinking and what factors contribute to drinking more than intended. This study investigates drinking intentions at the beginning of an evening and individual and situational factors associated with a subsequent consumption over the course of multiple nights. Using a smartphone application, 176 young people aged 16 to 25 (mean age=19.1; 49% women) completed questionnaires on drinking intentions, consumption, and drinking environments before, during, and after multiple Friday and Saturday nights (n=757). Multilevel regressions were used to investigate individual-level and night-level factors associated with previous drinking intentions and subsequent deviations from intentions. Participants intended to consume 2.5 drinks (SD=2.8) per night yet consumed 3.8 drinks (SD=3.9) on average. Drinking intentions were higher among those who frequently went out at night and engaged in more frequent predrinking. Participants drank more than intended on 361 nights (47.7%). For both genders, the number of drinks consumed before 8pm, attending multiple locations, and being with larger groups of friends contributed to higher consumption than intended at the individual and the night levels. Heavier consumption than intended also occurred when drinking away from home for men and when going to nightclubs for women. Making young adults aware of the tendency to drink more than intended, particularly when drinking begins early in the evening, moves from location to location, and includes large groups of friends, may be a fruitful prevention target. Structural measures, including responsible beverage service, may also help in preventing excessive drinking at multiple locations.

Attitudes and Practices Regarding Responsible Beverage Service: Focus Group Discussions With Bar and Restaurant Management and Staff.

Staff and management of bars and restaurants are the key players in assuring responsible beverage service (RBS) and preventing the overservice of alcohol to intoxicated patrons. We conducted six focus group discussions ( N = 42) with management and staff from bars and restaurants about RBS. We compared findings from these current discussions to results of focus group discussions conducted in the 1990s. In comparison to the earlier focus group discussions, we found that many managers and staff members had experience with RBS training programs, establishments generally had written alcohol service policies, and managers and staff members perceived greater likelihood of facing consequences from law enforcement for serving underage youth. Managers and servers also expressed greater concern about overservice of alcohol but did not report greater concern about potential legal consequences for overservice of alcohol than participants from the 1990s focus groups. Results of this study can inform training and enforcement approaches to addressing overservice of alcohol.

Evaluation of a responsible beverage service and enforcement program: Effects on bar patron intoxication and potential impaired driving by young adults

ABSTRACTObjective: Studies of alcohol-related harm (violence, injury, illness) suggest that the most significant risk factors are the amount of alcohol consumed and whether obviously intoxicated patrons continue to be served. This study's objective was to investigate the effects of a responsible beverage service (RBS)/enhanced alcohol enforcement intervention on bars, bar patrons, and impaired driving.Method: Two communities—Monroe County, New York, and Cleveland, Ohio—participated in a demonstration program and evaluation. The intervention applied RBS training, targeted enforcement, and corrective actions by law enforcement to a random sample of 10 identified problem bars in each community compared to 10 matched nonintervention problem bars. Data were collected over 3 waves on bar serving practices, bar patron intoxication, drinking and driving, and other alcohol-related harm from intervention and control bars and treatment and comparison communities.Results: In Monroe County, New York, of the 14 outcome measures analyzed, 7 measures showed statistically significant differences from pre- to postintervention. Six of those measures indicated changes in the desired or positive direction and 2 measures were in the undesired or negative direction. Of note in the positive direction, the percentage of intervention bar patrons who were intoxicated decreased from 44 to 27% and the average blood alcohol concentration of patrons decreased from 0.097 to 0.059 g/dL pre- to postintervention. In Cleveland, Ohio, 6 of the 14 measures showed statistically significant changes pre- to postintervention with 6 in the positive direction and 4 in the negative direction. Of note, the percentage of pseudo-intoxicated patrons denied service in intervention bars increased from 6 to 29%.Conclusions: Of the 14 outcome measures that were analyzed in each community, most indicated positive changes associated with the intervention, but others showed negative associations. About half of the measures showed no significance, the sample sizes were too small, or the data were unavailable. Therefore, at best, the results of these demonstration programs were mixed. There were, however, some positive indications from the intervention. It appears that when bar managers and owners are aware of the program and its enforcement and when servers are properly trained in RBS, fewer patrons may become intoxicated and greater efforts may be made to deny service to obviously intoxicated patrons. Given that about half of arrested impaired drivers had their last drink at a licensed establishment, widespread implementation of this strategy has the potential to help reduce impaired driving.

If it works there, will it work here? The effect of a multi-component responsible beverage service (RBS) programme on violence in Oslo

BackgroundThe Stockholm Prevents Alcohol and Drug Problems (STAD) programme has been regarded as one of the most successful programmes to date, in reducing alcohol-related violence. This multi-component Responsible Beverage Service (RBS) programme was implemented in Stockholm, Sweden, and has been documented to be extremely effective in reducing alcohol-related nightlife violence. The SALUTT programme in Oslo, Norway was carefully modelled on the STAD project. AimWe investigate whether the results from STAD were replicated in the SALUTT intervention. DesignUsing geocoded data, the level of violence in the intervention area was compared with different control areas before and after the intervention. StatisticsAutoregressive moving average models (ARIMA). FindingsThe SALUTT programme had no statistically significant effect on violence. However, the level of violence in the different potential control areas of Oslo fluctuated without a clear common trend. Hence, it was difficult to establish proper control areas. ConclusionsThe results from the Swedish STAD-intervention were not replicated in Oslo. Successful interventions are not necessarily replicated in other contexts, and the current literature does not shed sufficient light on the conditions under which such interventions actually work. Moreover, more attention should be devoted to the identification of adequate control areas in future research.