Issue 2 2004

The licensing of disorder

Melanie Phillips

Sometimes you really do have to rub your eyes at a world turned upside down. Our nannyish government which is trying so hard to stop us smoking or stuffing our faces with cream buns or behaving in other ways of which it disapproves is now encouraging us to take to the gaming tables.

The gambling bill published in June will relax the gaming laws to allow mega-casinos to spread across our towns and resorts. Slot machines will be able to offer £ million jackpots, and the new casinos will be able to provide as many fruit machines and gambling tables as they can cram in.

The result will be to bring Las Vegas to our towns and cities, with an almost certain increase in ruinous gambling and in the crime that inevitably attaches itself to gambling joints.

This is social progress put into reverse gear. Gambling is an innately destructive and antisocial activity. The danger that it leads people into ruinous behaviour is so pronounced that until now all governments felt a responsibility to keep it to a minimum. But now the Blair government has torn up that understanding. It is to usher in an explosion of gambling opportunities — which will mean an explosion of gambling.

Not surprisingly, those who deal with the casualties of gambling have registered shocked protests. The Methodist Church and the Salvation Army have warned of ‘potentially dire social consequences’, with the poor and other vulnerable people exposed to higher risks of gambling addiction.

By any rational standards, the government’s thinking is simply barmy. According to the Culture Secretary Tessa Jowell, the gaming laws have to be changed — because otherwise Britain’s achievement in having one of the lowest rates of gambling problems in the world will be at risk.

But it’s our gaming restrictions which have kept those problems low. How on earth will an invasion of giant casinos across the land mean fewer (ital ‘fewer’) gambling addicts, for heaven’s sake?

In fact, the government appears to be going to extraordinary lengths to turn Britain into a veritable crucible of disorder. For the relaxation of the gaming laws comes on top of the introduction of 24-hour drinking, the liberalisation of the law on cannabis, and the proposals for turning prostitution into a health-and-safety conscious legitimate business.

By relaxing the prohibitions against all this behaviour, thus giving a powerful signal that society no longer disapproves of it, the government is all but guaranteeing that it will not decrease but increase.

This is all the more staggering considering that the great social reform movements in the Victorian period were all directed at curbing such behaviour, and with remarkable success.

Considering the crucial role played by the Salvation Army and the Methodists in that heroic project of remoralising the poor, their current protests are particularly poignant. After all, it is often said that the British Labour party owed more to Methodism than to Marx.

Who would even have dreamed, therefore, that a Labour cabinet minister would have posed beside a roulette table as if she were placing a bet in order to launch a casino culture in Britain — and to claim that this was an example of social reform.

But then who would have imagined that a party ostensibly committed to social progress and rescuing the poor from squalor would go down the road of liberalising drug use or encouraging sexual promiscuity among the young, attitudes that have wreaked such havoc among the most disadvantaged in our society?

It is almost as if ministers sat down and looked at the great programmes of moral and social reform in the Victorian period, which were based on encouraging self-control and the restraint of appetites, and decided to put them all into reverse.

Those movements, teaching temperance and preaching against prostitution and sexual licence, remoralised an entire society which had become brutish and degenerate. For the Victorian reformers, the essence of being a progressive was to encourage people away from sexual promiscuity and the gin palaces.

Indeed, the only reason the British public house became a relatively civilised place was because the Victorians introduced licensing laws which stopped unlimited drinking, which was perceived to be a major cause of drunkennness and disorder.

Now we are undoing that very reform. Instead of being progressive, we are going backwards. Rather than promoting self control and continent behaviour, we are encouraging unlimited licence.

We are being returned to the 18th century, that dissolute era of libertinism and lotteries. The Victorians re-moralised a society. This government is demoralising it.

The tragi-comic aspect of all this is that ministers actually want to do good. They want to stop binge drinking, to reduce the disorderliness of prostitution. And they are correct to identify new forms of gambling which need to be controlled.

The problem is that they don’t grasp the crucial importance of laws which restrain behaviour. They don’t understand that these laws send out vital signals about social disapproval which encourage self–restraint. Demolishing the legal barriers gives the opposite signal that a free-for-all is perfectly acceptable. So antisocial behaviour is encouraged.

There is another huge pressure behind the encouragement of gambling, drinking and drugs. Those in charge of regenerating our towns and cities have spotted that the best way to make somewhere a ‘happening’ kind of place is to make it a centre of 24-hour entertainment.

That means pressure to open all-night clubs, pubs and now casinos. And that means a blind eye turned to the culture of drugs, drink and addictive gambling that fuels them. In other words, the economic regeneration of our towns and cities is being achieved through the marketing of vice —suitably regulated by the government, of course, with surreal ‘gambling free chill-out zones’ in the casinos and slot-machine free minicab offices. Big deal!

In its naïve way, the government looks at Europe where night life centres around civilised restaurants and fondly imagines that deregulation will turn Britain into a similarly pleasant café society. Alas, as anyone venturing into our inner cities late on a Saturday night can attest, the scene is more reminiscent of the work of the artist Hogarth, with vomiting, urinating, swearing and generally threatening and loutish behaviour.

The reason is that Britain is a very different culture from Europe. It needs strictly enforced rules and social signals to curb an innate tendency towards drunken yobbery and incivility which is a natural part of our people’s innately individualistic and rough and ready character.

But at the very heart of what has gone wrong is the collapse of the idea that anti-social behaviour is inherently wrong.

The Victorian reformers all had one thing in common. They were absolutely certain that behaviour such as drinking, sexual licentiousness or prostitution were wrong in themselves. That iron belief prompted them to try to curb what they clearly understood as vice and depravity. But now, anyone who even used such terms would be considered beyond the pale.

The only thing now absolutely unacceptable is to regard such behaviour as unacceptable. Instead we license it, regulate it and tax it — and then wonder why Britain is turning into a giant sleaze-pit. Nanny appears to need treatment herself for seriously dysfunctional behaviour.

Melanie Phillips is an award winning journalist and author. After a short period on New Society magazine, she joined the Guardian in 1977 and soon became its social services correspondent and social policy leader writer. After a stint as the paper’s news editor, she started writing her column in 1987, taking it to the Observer and then the Sunday Times before starting to write for the Daily Mail in December 2001.

Her web site is www.melaniephillips.com We are grateful to the Daily Mail for permission to reproduce this article.

The Strategy – after the long wait, humbug and evasion

Liquor-Speak

The long-awaited National Alcohol Harm Reduction Strategy has been found wanting by the Institute of Alcohol Studies. Biased, incoherent and dishonest are some of the terms used to describe a publication which, IAS says, is unworthy of a Government serious about reducing the massive burden of harm related to alcohol. The response points out the fundamental flaw that the document’s language and its thinking are permeated by ‘liquor-speak’ – “the ideas and vocabulary characteristic of alcohol industry statements and initiatives”, and which demonstrate consistent opposition to the findings of authentic scientific research..

The principal aim of liquor-speak is to emphasise the idea that “moderate and social drinking are clearly distinguished from ‘alcohol misuse’; that alcohol-related problems are experienced by only a small minority of miscreants; that there is no linkage between average alcohol consumption in a society and the prevalence of alcohol-related harm; that policies that restrict alcohol availability are ineffective or counterproductive; that ‘moderate’ drinking is in unqualified terms “good for you”, and that alcohol is not a cause of crime”.

Level of consumption

The IAS’s response states that the “most obvious and also the most telling omission is any proper recognition of the significance of the level of alcohol consumption in the population as a whole.” Although the Strategy makes the statement that present trends indicate that the United Kingdom will, within the next decade, rise to near the top of the consumption league, it fails conspicuously to draw any implication. It might have been hoped that the significance of this possibility would merit attention in a government document designed to deal with alcohol harm reduction.

The IAS points out the contrast between this attitude and “that of most other governments in Europe and elsewhere and also international bodies. For example, the World Bank states:

• The level of harm from alcohol is related to the pattern, including level, of drinking in a country. Time series analyses in western Europe find that overall mortality rises by 1.3 per cent for every extra liter of pure alcohol consumed per capita. But for Russia, where intoxication and hazardous drinking are more prominent, the corresponding figure is 2.7 per cent.”

As has been stated before in Alert, there is abundant international evidence that “increases in the overall level of consumption are normally accompanied by commensurate increases in prevalence of ‘alcohol misuse’ and in the indices of harm”. The response quotes the example of Ireland where, between the years 1990 and 2002, consumption rose by 41 per cent, an increase accompanied by rises in various types of harm: alcohol poisoning +35 per cent; suicide +23 per cent; cirrhosis +117 per cent; dependence +300 per cent; public order offences +246 per cent; assaults +82 per cent; drink drive offences +114 per cent.

At the same time, reductions in overall consumption are normally accompanied by commensurate reductions in the prevalence of high risk drinking and the indices of harm.

Despite all this the Strategy states that it “recognises that there are both benefits and costs to alcohol use and, therefore, does not aim to cut alcohol consumption by the whole population. Instead, it focuses on the prevention, minimisation and management of the harms caused by alcohol misuse.”

In response the IAS says: “This statement is a non-sequitur. It has never been suggested that the need to control overall consumption is either based upon or implies a denial that there are benefits from alcohol consumption. Contrary to the implication of the statement, there is no good evidence that reducing the overall level of consumption would reduce either economic or health benefits. For example, there appears to be no direct correlation between the population level of consumption and the numbers employed in the alcohol industry. In most circumstances,increases in alcohol taxes increase Government revenue while decreasing the economic burden of alcohol problems. In regard to health, in France substantially lower alcohol consumption has been accompanied by reduced mortality from heart disease.”

Prevention Policies

The response highlights a further major failing, pointing out that the Prime Minister’s comments at the beginning of the Strategy, and indeed the whole document, ignores the ‘prevention paradox’ – the finding that a substantial portion of alcohol problems and the costs associated with them are attributable to people who cannot be described as regular ‘alcohol misusers’. The explanation of the paradox, as has been shown clearly by research, is that, while compared with heavy drinkers, moderate drinkers individually have fewer problems, as there are many more moderate than heavy drinkers in the population they collectively contribute a substantial proportion of the harm. For example, a German study found that about 50 per cent of alcohol-related costs were associated with drinking by people not classified as alcohol dependent or with a diagnosis of alcohol abuse or harmful use.

The idea that the ‘vast majority’ are untouched by alcohol problems not only plays down the fact that alcohol problems are in reality more widely dispersed through the drinking population, it also fails to take into account the effects of alcohol problems on third parties.

According to the IAS, the importance of the Strategy’s rejection of preventative policies, which the research base suggests are likely to succeed in reducing harm, while promoting policies that the research suggests are generally ineffective, cannot be overstressed:

• “The two key policy choices here concern the price and the legal availability of alcohol. Higher prices of alcohol brought about by increases in tax have been shown to reduce morbidity and mortality from alcohol – related conditions such as liver cirrhosis, the incidence of homicide and other crimes including rape, robbery, assaults, domestic violence and child abuse, and also to reduce drinking and driving and binge drinking. Controls on hours and days of sale of alcohol, numbers of alcohol outlets, and restrictions on access have also been shown to reduce alcohol-related problems”.

On these policies the Strategy states:

• There is a clear association between price, availability and consumption. But there is less sound evidence for the impact of introducing specific policies in a particular social and political context:
• our analysis showed that the drivers of consumption are much more complex than merely price and availability;

• • evidence suggested that using price as a key lever risked major unintended side effects;

• • the majority of those who drink do so sensibly the majority of the time. Policies need to be publicly acceptable if they are to succeed; and

• • measures to control price and availability are already built into the system.

“So we believe that a more effective measure would be to provide the industry with further opportunities to work in partnership with the Government to reduce alcohol-related harm.”

The IAS’s response does not mince its words. As far as it is concerned, “this whole section is an exercise in dissembling:

• “The second sentence of the first statement appears to lack sense. How could the clear association between price, availability and consumption be established except in relation to particular social and political contexts?

• The second statement is nothing more than a version of the straw man argument – it has never been claimed that price and availability are the only factors involved.

• In regard to the third statement, theoretically any policy could be implemented ineptly or pressed too far. The argument is not that alcohol problems can simply be taxed out of existence but that without a sensible policy on tax, other preventive strategies will tend to be undermined.

• The fourth statement is another non sequitur. It is also humbug. The Government has pursued its policy of increasing the availability of alcohol against the wishes of the majority of the population. It has also reneged on its promise to lower the legal alcohol limit for drivers against the wishes of the majority of the population.

• To the extent that it is true that price and availability controls are already built into the system, this contradicts the implied thrust of all the preceding ones. The last statement offers a false choice. There is no reason why the existence of adequate price and availability controls should preclude partnership between the industry and the Government and, of course, the preceding sentence states that such controls are already built into the system.”

Education

The casual attitude of the Strategy to evidence-based policy is summed up in its comments on education. The Strategy document states: “The first key aim of the strategy is to improve the information available to individuals and to start the process of change in the culture of drinking to get drunk”. The IAS says. “Presumably, the assumption here is that the principal cause of bingeing is ignorance, a proposition for which if there is any evidence in support it is not presented in the strategy document. Nor is there is any real discussion of the significance or implications of the research findings showing that education is of very limited effectiveness in changing actual drinking behaviour.” The drink industry’s enthusiasm for education, which it communicates to Government whenever opportunity arises, may be connected to this ineffectiveness.

Who is responsible for making the strategy happen?

This question is the title of the crucial section of the Strategy. The answer provided is that although the Government – and it is clear from the context that it is the central Government at Westminster that is being referred to – has taken the lead in producing the Strategy, this responsibility is shared with individuals and families and the alcohol industry. There is also a reference to the important role of ‘communities’ in ‘taking ownership of, and enforcing, social norms.’

The response comments: “This perfunctory reference to ill-defined ‘communities’ cannot, however, disguise the fact that the crucial role of civil society in preventing alcohol-related harm is being almost completely disregarded. It is inconceivable that any effective movement to reduce the harm related to alcohol could occur without the active support and participation of a range of civil society organisations concerned with the main institutional sectors of society such as recreation, transport or the media, or with important social groupings within it, for example, youth organisations, womens’ organisations, family organisations, faith communities. Not one of them gets a mention in the Strategy document. Most bizarrely of all, the table listing the rights and responsibilities of the main actors involved in alcohol policy also omits local authorities, even though the Strategy is complementary to the Licensing Act 2003 which transfers to local authorities the responsibility for alcohol licensing. Also lacking is any reference to the extensive and rapidly growing network of residents’ and amenity societies concerned with the quality of life in town and city centres and which are necessarily heavily engaged in the alcohol, crime and disorder issues which are central to the Strategy’s concerns. For example, the National Organisation of Residents’ Associations in a mere eighteen months of existence has achieved 30 member organisations with a total of over 100,000 individual members.

The IAS response, which highlights the failings, disappointments, and contradictions of the Strategy, concludes on this vital theme of communal involvement in the problem of alcohol harm reduction, especially as regards the effects of the closely related new Licensing Act, which bizarrely appeared before the Strategy:

“The Government’s ambivalence – to put it no higher – towards civil society’s involvement in this area is one of the most important issues to have arisen in the context of the new Licensing Act. The original White Paper, Time for Reform, gave three ‘compelling reasons’ for transferring responsibility for alcohol licensing from the magistrates to local authorities – accountability to local residents; accessibility and the leading role of local authorities in preventing local crime and disorder, much of which is linked to the supply of alcohol. Yet one of the main purposes of the Act is precisely to place severe constraints on both the individual citizen and the local authorities in regard to what actions they are allowed to take in respect of licensed premises. For example, the Act restricts which residents are allowed to make representations about licensing decisions on the basis of where they live, with the result that many people who are profoundly affected by the decisions taken by their local authority will not have the right to make representations. The Ministerial Guidance that accompanies the Act is designed primarily to reduce the discretion of local licensing authorities, and to tell them what they are not allowed to do. For example, the Guidance makes it clear that the new licensing authorities will be expected to increase drinking hours substantially, irrespective of the wishes of the people who elect them. It is of note here that the Government repeatedly denied all requests that residents’ associations be represented on the Advisory Group established by the Department of Culture, Media and Sport to advise on the preparation of the new legislation. The bulk of the membership of this Group was of course provided by the alcohol industry, and a number of the meetings took place at the headquarters of the British Beer and Pub Association.”

Say no more.

The full response is available on the IAS web site or in hard copy from IAS, Elmgren House, 1 The Quay, St. Ives, Cambridgeshire, PE27 5AR

Researcher objects to drinks industry representative sitting on alcohol research body

Susan Mayor

A researcher working on alcohol dependence has criticised the appointment of the chief executive of a lobby group funded by the drinks industry to the United Kingdom’s Alcohol Education and Research Council (AERC) because he fears a potential conflict of interest.

Professor Robin Room, a professor at the University of Stockholm and director of the Centre for Social Research on Alcohol and Drugs in Stockholm, Sweden, was concerned by the recent appointment of Jean Coussins, chief executive of the Portman Group. The group was set up in 1989 by UK drinks producers, and its main aim was “to promote responsible drinking.” Ms Coussins was appointed by the secretary of state for culture, the government department that oversees the work of the AERC.

The AERC aims to increase awareness of alcohol issues, facilitate a reduction in alcohol related harm in society, and encourage best practice. To achieve these aims, it funds research, education, and training for people working on issues related to alcohol.

It was established in 1982 to administer the Alcohol Education and Research Fund, a charitable foundation established with assets from a levy on public houses that was originally designed to compensate owners who lost their licences because of a decision early in the 20th century to reduce the number of pubs. Because of this derivation of the money, three members of the board of the AERC have always been nominated by the alcohol industry.

Professor Room said that up to now this arrangement had seemed unproblematic. However, he considered that the appointment of Ms Coussins— who replaces one of the current industry representatives—was potentially a problem because of the Portman Group’s lobbying role and previous stance on alcohol research. He said: “The Portman Group had taken a relatively confrontational line towards alcohol research which does not fit its preferred view of the world.” He noted that the group had been exposed in 1995 for offering money to scholars for negative views on a World Health Organization report, Alcohol Policy and the Public Good.

Professor Room continued: “In my view, an organisation which has taken such a partisan position specifically on research findings should not be on the board of a semi-governmental organisation which is supporting alcohol research with public money.” He added: “If a Portman Group staff member remains on the AERC board, it will severely compromise the AERC’s reputation and capacity to function as a scientific funding body operating in the public interest.” Professor Griffith Edwards, emeritus professor of addiction at the Institute of Psychiatry, London, and editor of Addiction, agreed: “Jean Coussins is not a representative of the brewing industry but of a lobby group. The Portman Group has lobbied government intensively on behalf of the drinks industry, arguing that it is not drinking that matters, but drunkenness. “They have advocated education (which doesn’t work) and voluntary codes of practice (which are difficult to enforce). They have also put out grossly misleading statements saying that there is no scientific evidence for a public health approach to alcohol use. For an organisation committed to traducing science to be on a grant giving body seems a step too far.” He considered that the appointment would damage the reputation of the council.

Dr Noel Olsen, chairman of the council, said: “The debate on whether industry should be represented [on the AERC’s board] needs to be aired. I will advise the council that we need to talk to the government departments we work with and alcohol organisations to reach a view on what is right.” He is raising the issue of whether it is right for industry to have seats on the council, and whether the Portman Group is an appropriate group to be represented on the council. This discussion will take place over the next few months. He added: “The government strategy—rightly or wrongly—has decided that their alcohol strategy will be a partnership between industry, government, and alcohol organisations.” The Portman Group claimed on its website that it was a principal provider of responsible drinking advice in the United Kingdom and supported the government, media, industry, and consumers with research, educational materials, and campaigns. Ms Coussins was unable to comment on her appointment to the council, other than to confirm that it had been made.

We are grateful to the British Medical Journal for permission to re-produce this article which first appeared in BMJ 2004;329:71.

Doctors demand tough action

Royal College of Physicians calls for decisive Government action on tackling public health issues The Royal College of Physicians has called for decisive Government action on tackling public health issues such as smoking, obesity, excessive alcohol consumption and sexually transmitted disease.

In its response to the Government consultation document ‘Choosing Health?’, the Royal College says that the serious medical consequences of smoking, obesity, excessive alcohol consumption and sexually transmitted disease require decisive leadership and action by Government.

The College’s response, which includes for the first time comments from the RCP Patient and Carer Network, covers smoking, alcohol, obesity, sexual health and inequalities in health, looking in detail at short- and long-term objectives; policies necessary to stem the tide of illness and support preventive health; and the organisational facilities needed.

The College identifies several factors that the various health risks have in common with each other in terms of the challenges facing Government, industry, health professionals and society:

• All disproportionately affect the vulnerable in society, the young, the deprived and the disadvantaged

• All require more socially responsible approaches to the advertising, marketing and promotion of products, which, if used at all in the case of tobacco, or unwisely in the case of alcohol and diet, cause ill-health and premature death

• Premature death and ill-health from the above causes are preventable, and could be significantly reduced by public education and health promotion to encourage healthy behaviours

• All form a substantial cost to society, not just through the costs to the NHS, but also in terms of wider costs to society such as lost production, costs to social services, and reductions in quality of life

• All have implications for the training and education of health professionals and their practice

The response identifies clear actions and measures that should be taken to address these challenges. RCP President Professor Carol Black said: “The evidence supporting the need for action is beyond dispute. These are major public health issues of our time. We look to Government to lead.”

Government launches crackdown on drunken violence

Spiralling public concern over drunken violence prompted a double-header of Government initiatives. An initial summer blitz on irresponsible premises and ‘drunken yobs’ was followed less than two weeks later by the Home Office’s Strategic Plan, which among plans for police reform also sets out how the Government plans to achieve its major aim that “fewer people’s lives are ruined by drugs and alcohol.”

The need for action – and the perhaps more important need for the Government to be seen to be acting – was heightened by the publication of official statistics showing a rise in recorded violent crime, despite longer-term drops in British Crime Survey (BCS) figures.

However, the document really adds little to the ‘summer alcohol misuse enforcement campaign’ and the Alcohol Harm Reduction Strategy for England published earlier in the year. One additional measure is that 20,000 new Community Support Officers will be recruited, quadrupling the number currently in existence, which – along with greater numbers of police officers and others freed from paperwork – is hoped to reinforce the police presence on the streets of the night-time economy. Similarly, a move towards Neighbourhood Policing will allow greater neighbourhood involvement in tackling anti-social behaviour. Although the details of this will not be announced until later in the year, neighbourhood wardens with powers to tackle irresponsible alcohol sales see likely after having been mentioned in the Strategic Plan.

The more immediate battle to assuage public fears started on 8 July, as police units across England and Wales started to tackle sales to minors and badly run bars and clubs as well as the ‘drunken yobs’ who create the climate of violence in urban centres at weekends. This Home Office campaign (supported by the Association of Chief Police Officers (ACPO) and Trading Standards Authorities) will not receive any new powers, but will instead shore up the use of powers they already have by law.

When the 8-week campaign ends after the August Bank Holiday, the Police Standards Unit (PSU) based in the Home Office will collate data on the number of enforcement actions taken and look at the repeat offenders in selling to U18s. More ambitiously, the PSU hopes to “kick start a culture change where it will be less acceptable to get drunk and behave in an anti-social or violent manner.”

The campaign builds on a briefing recently published by the ever-busy PSU on Best Practice for tackling alcohol-related violence. This summary of tactical options was promised in the Prime Minister’s Strategy Unit report, and is designed to be a reference document for Crime and Disorder Reduction Partnerships (CDRPs) and police forces from which they should choose the most suitable options for their own area.

Success stories from around the country are based around a number of themes, including the idea of ‘capable guardians’ – that someone is less likely to break the law if they think someone is watching them. While this ‘someone’ can be a policeman it could also be bus conductors or even non-humans such as better lighting. The mechanical eyes of CCTV are often cited by the PSU as helpful, whether in fixed or mobile positions, in licensed premises or in taxis. More traditional flesh-and-blood approaches include bus and taxi marshals, mobile triage/A&E units for pre-planned events and refuse collectors (who can also remove potential weapons from the street).

This fits neatly into the more general aim of reasserting the authority of the police over outdoor areas containing drinkers. The most common way of achieving this is the most obvious – simply devote more officers to peak-time policing in these areas with mobile police stations to support them. Yet the powers conferred on the police by recent legislation allow them to take further action to regain control over areas that are causing concern, ranging from search powers to alcohol prohibition zones via confiscation of alcohol from youth street drinkers. One effective method has been to take a robust approach to low level disorder in hot-spots that can come before violence (such as littering, urinating, offensive language). If these offences are recorded on databases then a real threat can be made that repeat offences within 6 months will result in prosecution.

A second prominent strand of action tries to ease the pressures that lead to the types of conflict that escalate into violence. This is the argument for staggered closing times, although whether the new Licensing Act will actually succeed in staggering closing times, or if it does whether that will have the desired effects remains to be seen. But the PSU offer a number of other illustrations of how to tackle late-night violence based on this idea. One of the major strains is late-night transport or the lack of it, where large numbers of revellers often compete for a limited number of taxis to make their way home. To tackle this, local authorities and police forces have tried to ensure that taxi ranks are situated well away from any other transport hubs (including other taxi ranks). In the same vein, subsidised peaktime buses – that can be cash free with tickets on sale only in clubs – are an effective way of reducing competition for transport. Another tactic is to set up a pedestrian zone around clusters of licensed premises, which not only stops disputes over passing taxis but has the added bonus of reducing the number of drinkers who are involved in traffic accidents. Taking the same concept into other areas, clashes over late night food can be combated through local authority incentives to site these outlets in areas of current low provision, again spreading out services to minimise the chances of violence.

One recurring theme for Home Office Ministers has been getting to grips with ‘rogue’ licensees, and Hazel Blears followed this when launching the summer crackdown campaign: “most of the alcohol industry act responsibly, but with this campaign we are putting across a clear message – if you sell to underage drinkers, if you promote violent and anti-social behaviour, you’re not going to get away with it and we will use a raft of powers shut down your premises.” Although the Best Practice guide makes no explicit mention of temporary closures, the same message is clearly visible throughout it as well. The ‘conscientious’ arm of the trade is expected to help with ‘Quality Charter Marks’, proof-of-age wristbands and ‘No ID no entry’ schemes, visible doorstaff with ID, Night Net radio/paging systems and safety glasses (although several of these can be linked to license conditions and CDRP subsidies). But ‘rogue’ premises can expect to see test purchasing, telephone numbers to report underage sales and proactive licensing teams using reports from the street fed into licensing databases. Experience has also shown that drawing in other agencies can help – the same places that are run without regard to public order may be susceptible to joint visits with Environmental Health, the Fire Service, licensing authorities et al. The PSU also recommend a strategy halfway between partnership and enforcement, by using videos of hot-spots (taken during routine visits) to confront licensees with examples of irresponsible promotions and poor management to get them to change their own behaviour.

These varied approaches that work on the drinking climate are bolstered by policing that focuses on the two sets of people who are actually involved – the victims and the offenders. For victims, the scope of what the police can do is limited to three core ideas. Firstly, referral for those who have suffered some form of crime where drunkenness has played a part can support the victim through the criminal justice process, giving instant benefits in prosecution success and more broadly giving the public more confidence in the police. Secondly, evidence and intelligence should be gathered as a matter of course at the start of the process in case of prosecution without the victim’s consent, and can be helped by linking up with NHS Primary and Acute Trusts who treat victims. And finally, high-profile campaigns can give potential victims information on avoiding trouble by suggesting safe routes home, showing details of public transport and telling people the risks of drunkenness.

Yet none of this can compete with the strong arm of the law in taking hold of ‘drunken yobs’ by the scruff of the neck (at least, not in the popular imagination). Police forces nationally have made progress by picking from a menu of possible powers – alcohol purchase bans for repeat offences, exclusion orders, ASBOs, acceptable behaviour contracts, victimless prosecutions and fixed-penalty notices. The chances of taking an offence through the criminal justice system are also enhanced by Post Arrest Support Teams, who can come to the scene of a crime and make sure it is investigated as thoroughly as possible while maintaining a visible presence on the street. To make the most of these measures, the PSU also urge forces to publicise the convictions that take place to reassure the public as well as to get the point across to potential offenders.

Recognising the public outcry over current disorder, the drinks trade have accepted the Home Office campaign despite bracing themselves for a slight dip in profits as a result. The Wetherspoon’s chain publicly justified this to their shareholders by arguing it was in their ‘long-term interests’ for them to accept the strategy – implying that they want to use this opportunity to head off the threat of further legislation that could more seriously affect their profit margins.

It is suggested that the bans last three years and are given to those convicted of three offences related to drunkenness within a 12-month period.

Those convicted of violent offences in licensed premises are banned from them.

Acceptable Behaviour Contracts/Agreements (ABC/As) are informal contracts between young people, their parents and local agencies (for example the police, housing landlords, schools and Youth Offending Teams), that the person concerned will not engage in specified anti-social behaviour. They also spell out the consequences of breaking that agreement.

Anti-Social Behaviour Orders (ASBOs) are for those who engage in more persistent antisocial behaviour, and stop specific acts or ban offenders from particular areas. The process has recently been speeded up. For example, an interim ASBO can now be sought in a matter of hours. The Home Office also promises to take action to ensure that it is easier for local media to report prosecution for breaches of ASBOs.

Fixed penalty notices for disorder offences that provide both a rapid sanction and a warning to stop, without the need for a case to go to court. Over 20,000 such notices have been issued to date and we are expanding the range of offences for which a fixed penalty notice can be issued. We propose to extend them to include misuse of fireworks, criminal damage, and minor theft. Use of fixed penalty notices for ten to fifteen year olds will also be piloted. They are currently used for those aged sixteen and over.

Drink driving – Government rejects its own evidence

There has been a bizarre twist to the long-running story of its refusal to lower the drink drive limit. The Government has again dismissed as of no account its own evidence that doing so would save lives, while simultaneously announcing a publicity campaign warning of the dangers to road safety of blood alcohol levels well below the present legal limit.

In answer to a question from Lord Avebury, Government spokesman in the House of Lords, Lord Davies of Oldham, stated that drink driving is at present ‘under control’ and that targets are in place to reduce the overall number of accidents by 2010. He added, “But at present there is no indication that we would improve the statistics… by reducing the blood alcohol limit.”

Lord Davies’ claim that drink driving is under control may be considered of doubtful validity given that after years of falling the drink drive casualty figures are now increasing. The figures for 2002, the latest year for which figures are available, were the highest since 1990.

However, Lord Davies’ assertion that there is no evidence that lowering the drink drive limit would help matters is even more questionable in view of the evidence that the Government itself published in 1998 that reducing the blood alcohol limit from 80mg per cent to 50mg per cent could save up to fifty lives and prevent around 250 serious and 1200 slight injuries per year. At that time, the Government explained that driving below the 80mg per cent limit was a significant but largely hidden cause of road traffic accidents and that it therefore intended to lower the limit to 50mg per cent.

The Government’s calculations were in line with evidence from abroad. It is estimated that in Australia, Austria, Belgium, France and Sweden, lowering the legal blood alcohol limit for drivers cut the number of road deaths by between 4 per cent and 18 per cent. The evidence suggests that lower legal limits for young drivers may reduce fatal crashes in this group by as much as 24%.

In 2002 the House of Lords European Committee blamed the Government’s failure to lower the limit on the undue influence of the alcohol industry’s Portman Group. Assuming the accuracy of the Government’s estimates, since 1998 this influence has cost some 250-300 lives, and around 7,500 injuries.

Just hours after Lord Davies had stated that lowering the limit would not help, Road Safety Minister David Jamieson launched a new £1.4 million publicity campaign aimed at young drivers and graphically depicting the dangers of having even a couple of drinks before driving. The accompanying fact sheet explains, “Even a small amount of alcohol will make you a worse driver. You don’t judge speed and distance so well and your reactions are not as fast.” The 80mg% legal limit does, of course, allow drivers to consume considerably more than a couple of drinks.

The Government conceded that the new campaign was prompted by the increase in drink drive related deaths and injuries.

Ofcom revises rules on alcohol advertising

Ofcom has announced new draft rules on the television advertising of alcoholic drinks. The subject has been debated for some time, often heatedly. It has been felt by many clinicians and people working in the field of alcohol policy that the drinks industry was getting away with a great deal too much, especially when aiming its advertising towards young people. A particular area of concern has been the use of sexual images and the implication of enhanced sexual performance or attractiveness.

The industry has become increasingly aware that it was open to criticism and has been active in making attempts to forestall any move towards statutory regulation of advertising. Its problems, of course, have been less immediate in the United Kingdom, where the Government listens very closely to what the industry and its front organisation, The Portman Group, have to say.

The draft rules which now appear were drawn up in response to views expressed, inevitably, by the drinks industry and also by consumer groups that existing rules, inherited from the Independent Television Commission, were insufficiently focused with regard to:

• Discouraging advertising likely to be strongly attractive to children and young teenagers.

• Discouraging advertising which appears to condone anti-social behaviour related to drinking, particularly with implications of excess consumption.

• Discouraging an implied linkage between drinking alcohol and sexual success. As far as concessions go, the industry has made small steps towards stating the glaringly obvious and now agrees to do what it might well have been expected to be doing all along. Alcohol advertising on television has been subject to specific rules since the beginnings of commercial television in the United Kingdom. In 2003, Ofcom’s predecessor, the Independent Television Commission, had research carried out to assess whether the current rules remained effective and appropriate. Ofcom states that it “has taken forward that research, whose principal elements include:

• • Two reviews of academic literature which indicate that alcohol advertising has some impact on young people’s attitudes to alcohol. However, this is at a relatively low level compared to other influences within the wider family and social environment.
• • A qualitative study which indicates that a good deal of television advertising – of alcopops in particular – is closely aligned to youth culture and of strong interest to underage drinkers. However, the research demonstrates that advertising which does not seek to make a linkage with youth culture and which features older people is much less attractive for children and younger teenagers.”

The first point minimises clear evidence that alcohol advertising does influence young people. No-one would argue that the social environment and family have a greater effect but that is not to say that there is an obligation on advertisers to ensure that their products are not made attractive to under-age drinkers.

The second point makes two unconnected statements in a manner which implied that the second mitigates the first, which, of course, it does not. The barest familiarity with alcohol advertising makes it abundantly evident that a substantial proportion of it is strongly aimed at young people. The fact that the proportion aimed at older customers is unappealing to youth is neither here nor there.

Ofcom states that it “has reviewed the current rules in light of the research findings. It is now seeking views on proposals to strengthen the rules. The proposals are targeted at the following specific issues:

• Condoning anti-social or self-destructive behaviour.

• Linking alcohol with sexual activity or attractiveness.

• Reducing the appeal of the advertising to young audiences.

• Condoning the irresponsible handling or serving of alcohol.”

In March 2004 the Cabinet Office identified television advertising of alcoholic drinks as one of many potential factors relevant to its wider strategy on alcohol harm reduction. Ofcom believes that “the evidence from the research, combined with the views of stakeholders, indicates that a tightening of the existing rules on defined aspects of alcohol advertising would be proportionate and would be likely to make a contribution to that wider strategy”. Nevertheless, indications are that Ofcom will shy away from suggesting further statutory regulation of the drink industry and its advertising, leaving it to the system of self-regulation for which the industry has campaigned so vigorously. Those who have observed the influence exercised by the industry during the passage of the new Licensing Act and the formulation of the Alcohol Harm Reduction Strategy will not be surprised.

The full consultation document and related research is available on Ofcom’s website at www.ofcom.org.uk. The closing date for responses to the public consultation is 24th September 2004.

Planning for the sale of alcohol

Current concern over binge drinking has given rise to a debate on ways of tackling the problem using the planning and licencing systems. There is a particular concern about density of outlets. Here Linda Hill reviews the international literature on the subject.

Liquor licensing is one means by which communities can control the sale of alcohol and encourage server responsibility and compliance with laws such as the age of purchase. Local planning regulations also allow communities control over appropriate location of alcohol outlets and similar matters.

A liquor licence is a privilege that allows the licensee to sell alcohol when others may not. Compliance with licensing laws is enforced by suspending or cancelling the licence. This is necessarily a reactive approach – a big enough problem has to occur before something can be done about it. In contrast, town planning decisions operate prospectively – that is, planning and zoning rules help shape the future. Effects may not always be immediate, however. Existing outlets may be protected, making past patterns slow to change unless a community has a high turnover of licensed businesses.

Nevertheless, local government policies and planning decisions about numbers and location of on-licensed premises and off-licensed outlets allow communities to take local alcohol related risk into consideration before it becomes local alcohol related harm.

The USA and Canada provide examples of municipal governments using zoning powers to exercise local control over alcohol outlets.

Examples from the USA

In the US, the 21st Amendment to the Constitution allows state legislatures to regulate the sale of alcohol. This is done through liquor licensing systems, although 17 states control sales ‘by the bottle’ through state stores monopolies. Many states have regulations limiting the number of bars or bottle stores in relation to population numbers. A state may delegate its licensing powers to cities or counties. Localities that do not have licensing powers often use their zoning powers to control alcohol sales in their area. Zoning decisions can be slow and complex, and the city needs to show that the proposed ordinance would reduce harm to the community. This is indicated by US research linking alcohol-related harm to the number and density of alcohol outlets in the neighbourhood.

A range of zoning strategies are used. In some states (and in Canadian provinces), a whole city or county can be voted ‘dry’ through a ‘local-option’ election. When Barrow, Alaska voted to do this, assaults and emergency room visits decreased significantly. They increased sharply when the ban was lifted and declined significantly again when it was reinstated. Zoning can be used to prohibit the sale of alcohol in certain areas – usually in residential zones, but has also been used in some downtown areas. California took the lead on this in the mid 1980s. Cities and counties began to use zoning rules and conditional use permits to control the location and operation of alcohol outlets. For example, zoning rules may allow licensed restaurants but not bars or off-licensed sales in an area, or may prescribe the hours during which alcohol may be sold. When zoning changes led to the closure of several alcohol outlets in Union City, California, youth violence decreased significantly in those neighbourhoods.

Zoning is also used to create ‘buffer zones’ between licensed premises and community facilities such as schools or churches. For example, liquor licences are not granted to businesses within 1,000 feet of a park, church, school, day care centre or government building in Tampa, Florida, within 1000 feet of a school or church in Bloomingdale, Indiana and Orlando, Florida, or 300 feet in Minneapolis. In Pasadena, California, the Municipal Code created a rule about outlet density that ‘overlaid’ the city’s existing zones and planning requirements. Any new licensed premises, or any existing outlet that wants to sell spirits as well as beer or wine, must be either 250 feet or 1000 feet from any other licensed business. Notification of the application must be posted on the site, and neighbours within 300 feet must be notified.

Drinking by college students is a particular concern in the US. To reduce the number and concentration of bars and bottle stores near campuses, some communities have introduced new zoning laws, or stricter enforcement of existing building and zoning codes. Others have reduced the number of premises by increasing the cost of alcohol licences.

In many states, zoning restrictions may be used to protect the health, safety and welfare of the community, provided a relationship is established between the community problems and the activity restricted.

Disproportionate concentration of alcohol outlets in poorer neighbourhoods has become a concern in many communities. In South Central Los Angeles, residents used conditional use permit requirements to prevent the rebuilding of 200 liquor stores burnt down in the civil unrest of 1992. Requirements included limited hours of operation, security, and lighting and cleanliness outside the premises. When Oakland took a similar approach with currently operating alcohol outlets, the US Court of Appeals confirmed that this was a valid use of city authority that overrode existing land use rights.

In Chicago, Illinois, by 1997, 36 out of 50 wards had changed their zoning rules to place a moratorium on new licensed premises or retail outlets. The moratoriums were brought about by community campaigns, either via a local referendum or via city councillors and a planning ordinance. As well as preventing new liquor licences, “a moratorium sends the message that the community cares enough to take action”, said the researchers who documented these campaigns. Community action included increased monitoring and enforcement of laws and regulations governing outlet management. In Illinois, differential rating for particular areas can be used to fund special services. This has paid for extra late night hours for security staff near licensed premises and for extra street cleaning.

Zoning and similar planning controls were also part of a full evaluated, five-year community action project, that the World Health Organization cites as ‘exemplary’. Community action projects in three middle-sized communities in Northern and Southern California and South Carolina were compared with matched communities which did not have projects. Each locality organised its own programme of action. These included mobilising the community, media coverage, server training, initiatives to reduce off-licence sales to minors, enforcement of drink-driving laws. All three communities made alcohol access and availability a priority for action. Zoning and other local government powers were used to address the number, density and management of alcohol outlets. Community members knew about problems with local alcohol outlets and drew on scientific evidence about the relationship between alcohol availability and alcohol problems. They found that local planning, zoning, licensing and enforcement tools were available to address these problems, even if they had not been used in the past. These included reviewing consents decisions, making alcohol sales a conditional land use so as to allow case-by-case control, developing a model Conditional Use Permit that included the restrictions set by the council, limiting areas of permitted location and creating buffer zones. All three communities met set-backs or easing of regulations for downtown areas, however, as some business and political interests supported rapid outlet growth as part of local economic development.

Examples from Canada

In Canada, alcohol laws are made by the provincial government, but city councils are increasingly using their planning powers to exercise local control. As in some US states, provincial laws often restrict alcohol availability through a provincial government monopoly over takeaway alcohol outlets. These have come under political pressures for privatisation, including challenges under free trade treaties.

In 1993 the Alberta provincial government privatised its liquor stores and the number of outlets almost doubled. The monopoly had kept prices high but over the next year per capita consumption increased in Alberta, compared with decreases in the rest of Canada. The City of Edmonton was concerned that new outlets would create and concentrate problems in certain parts of the city. Licensing and hours of operation were the responsibility of the Provincial government, and it was likely that it would consider local use of zoning ordinances to control density directly to be a restriction on competition. Edmonton’s response was to define two new and uses by size of outlet – major and minor alcohol sales –distributed through most commercial zones. There were also new rules to separate liquor stores from schools and other public facilities. On-licensed premises were also restricted by size and number of seats. More recently, changes in alcohol regulations, reduced monitoring by the Alberta licensing authority and poorly operated premises led to growing concern in some neighbourhoods. A larger number of more precise land use classes was adopted, together with new rules on permitted and discretionary uses, covering such things as outdoor patios and sound systems. This allowed greater flexibility on how different kinds of premises or retail outlets were distributed in five different commercial zones and provided a sounder base for regulating land use and local impacts.

Ottawa has revitalised its inner city on a ‘festival marketplace’ model. This resulted in increased nuisance from licensed premises and from public drinking. Youth parties were being organised and held in private car parks. This was addressed with a zoning rule that prevented ‘public assembly with commercial intent’. City officials also held cross-sectoral negotiations with the parking lot operators, adjacent bar owners, police and the Provincial licensing authority with its power to withdraw liquor licences. They also addressed community concerns about public safety and inner city residential amenity with a bylaw controlling the location of large bars and placing a moratorium on new bars over 500m2 in size.

References

Ashe, M., D. Jernigan, R. Kline, R. Galaz (2003) Land use planning and the control of alcohol, tobacco, firearms and fast food restaurants. American Journal of Public Health 93(9): 1404- 08; see also the Center for Health Information’s Health Policy Guide on conditional use permits and zoning and other ordinances http://www.healthpolicycoach.org/

Parker, R. Nash and R.S. Cartmill (1998) Alcohol and homicide in the US: Or one reason why US rates of violence may be going down. Journal of Criminal Law and Criminology. 88(4): 1369-1398. Higher Education Center (sighted 21.7.2004) Curtailing alcohol outlet density is key factor in college alcohol prevention. March. www.edc.org/hec/

Maxwell, A. and D. Immergluck (1997) Liquorlining: Liquor store concentration and community development in lower-income Cook County neighborhoods. Woodstock Institute, Chicago. Addiction Special Issue 1997;

Reynolds, R.I., H.D. Holder and P.J. Gruenewald (1997) Community prevention and alcohol retail access. Addiction 92: S261-S269.

Gruenewald, P.J., A.B. Millar and P. Roeper (1996) Access to alcohol. Alcohol Health and Research World 20(4): 244-251.

Grieshaber-Otto, J., S. Sinclair and N.Schacter (2000) Impacts of international trade, services and investment treaties on alcohol regulation. Addiction 95 Supplement 4: S491-504Grieshaber- Otto, Sinclair and Schacter 2000.

Her, M., N. Giesbrecht et al. (1999)Privatizing alcohol sales and alcohol consumption: Evidence and implications. Addiction 94(8): 1125-40. City of Edmonton (2000) City Shaping: Choosing directions for planning and developing Edmonton in the future. A process of bylaw reform, Issues Report. November.

Turnbridge, J.E. (2001) Ottawa’s Byward Market: A festive bone of contention? Canadian Geographer 45(3): 356-370

Research links density of alcohol outlets to local levels of harm

Linda Hill

New geo-spatial research methods are improving our understanding of how local environments shape the level of alcohol-related problems experienced by communities. A growing body of research shows a relationship between alcohol outlet density, drinking and harm that is most marked at the neighbourhood level. The research literature reviewed below suggests that reducing the number and density of alcohol outlets can reduce heavy drinking and local alcohol-related harm, such as violent crime.

Studies in the USA in the 1980s and early 1990s showed a relationship between alcohol outlet density and alcohol consumption levels that was mutually reinforcing over time. This was followed by research in medium-sized US cities that linked alcohol outlet density to specific measures of alcohol-related harm such as drink-driving and violence. Findings from city-level data do vary between different parts of the USA, but analysis of neighbourhood level data consistently shows a significant link between outlet density and harm after controlling for sociodemographic and other relevant factors. These findings can inform policing and licensing decisions, as well as the wider policies of local and central government.

One of the earliest studies, of 213 California cities, showed that a 1 per cent increase in beer bars resulted in more than 1 per cent increase in public drunkenness and drink driving. Other Californian research linked high outlet density to high numbers of night-time traffic crashes and pedestrian injuries in the neighbourhoods studied, with some spill-over effects into neighbouring areas.

Research in Newark, New Jersey, showed that alcohol outlet density was the single greatest predictor of violent crime at the suburb and neighbourhood level (census tracts and census blocks). This link with harm levels holds good whether density is measured per head of population or per square kilometre. California studies linked the density of off-licensed outlets to violent assault, including violence involving young people. In an average city in Los Angeles County, each additional outlet was associated with a 0.62 per cent increase in violent offences. In New Jersey, alcohol outlets, along with bus stations and all-night businesses, appeared to become crime ‘hotspots’. The effect of high outlet density on crime was specific to the area, however, with little of spill-over into neighbouring areas that occurs with alcohol-related driving offences.

One New Orleans study of outlet density is relevant to the debates about personal choice versus community responsibility that often come up when intervention in the alcohol market is proposed. It shows how the link between outlet density, drinking and harm works through the social norms that are created within communities. Rather than affecting individual behaviour directly, the density of alcohol outlets in a community has a structural effect on alcohol attitudes and drinking patterns across that community that then influences the attitude and drinking pattern of individuals.

In this study, urban residential census areas were randomly selected to provide three examples each for hig and low outlet density and four different levels on the socioeconomic deprivation index 24 areas in all. A random telephone survey of 2,604 adults in these areas asked abou personal drinking and attitudes to alcohol including social acceptability and perceived norms for friends, and distance from an off-licence (as a proxy for density), as well as sociodemographic information. The analysis looked at drinking and attitudinal differences between individuals and also between averages for each area. For individuals, all the variables except density were strongly linked to drinking norms; male sex and higher education were more likely to mean heavier drinking; black ethnicity and increasing age were associated with drinking less. Distance from home to the closest off-licence made no difference. However, 16 percent of the variation between individuals on perceived drinking norms and 11.5 percent of variation in self-reported drinking related to where the individual lived. When the data was analysed by neighbourhood, the average distance to nearest outlet for each neighbourhood was the only variable that linked to averages on attitudinal and drinking measures. That is, in neighbourhoods with low distances on average to the nearest off-licence, there were heavier drinking norms.

In the researchers’ view, this finding indicated that in a high outlet density area, whether you live next door to a liquor store or a kilometre away, everyone’s drinking norms are affected to some degree by the neighbourhood environment. This is consistent with social learning theory and with research from other countries that shows individual drinking behaviour is influenced by the drinking behaviour of one’s social network. For example, research links heavier drinking among 10-17 year olds and among university students to perceptions about drinking by friends that overestimate their actual consumption.

A high density of alcohol outlets increases the visual presence of alcohol in a neighbourhood, and may have similar effects on attitudes and norms as high exposure to television, print and billboard advertising for alcohol. The presence of alcohol outlets, including signage and empty bottles or intoxicated patrons in the street, may also have a ‘broken window’ effect, suggesting that ‘no one cares’ in this neighbourhood. Concentrations of bars and bottle stores can act as ‘attractors’ of socially disinhibited people and help create the conditions for non-normative activities such as drug use and prostitution. This, as well as the effects of increased drinking in the neighbourhood, may contribute to the link between outlet density and violence.

The type of outlet linked to increases in harm varies between the US studies. Differences appear to be related to local patterns of drinking and risk and reflect licensing system differences between US states. In New Orleans it was the density of off-licensed premises that made a difference, with researchers pointing out that the data for on-licensed premises would include many serving the tourist industry rather than the local population. No such distinction could be made in the New Jersey study, where licensed premises usually have both on and off sales. In Californian studies, the density of licensed restaurants affected alcohol-related crash rates, as alcohol was twice as likely to be consumed in restaurants than in bars , but bar density was linked to higher assault rates. Research on different types of licensed premises in Perth, Western Australia, did not consider density but linked intoxication levels, drink-driving, alcohol related crashes and violence to late-closing hotels (pubs), particularly those with high volume alcohol sales.

High local crime rates are better explained by alcohol availability and outlet density than by the socio-demographic characteristics of the neighbourhood – although those characteristics may contribute to the level of community organisation and control over what happens in a neighbourhood. In the USA, whites and those with higher incomes are most likely to drink frequently and heavily. Yet in Chicago, areas with high African American population had six times as many off-licensed outlets as areas with mainly white populations. The concentration of alcohol outlets, particularly off-licences, was a major predictor of homicide levels, after controlling for other neighbourhood factors. That is, higher ratios of blacks or young males in a neighbourhood did not explain a higher crime rate. The California and Los Angeles studies also showed that alcohol availability and outlet density in communities were stronger predictors of the level of violence than race or ethnicity. Researchers go so far as to suggest that the over-representation of African-Americans in US violence statistics may result from neighbourhood-level risk factors rather than from personal or cultural characteristics. A review of crime in the USA attributed a decline of homicide to falling alcohol consumption, and presented evidence that tighter regulation of alcohol availability could help reduce violence.

These studies link density to harm statistics, which are most readily available for drink-driving and violent crime. The Chicago study, which reports community action in lower income Chicago neighbourhoods, describes other negative effects of high liquor store density:

Typical complaints include the serving of minors, littering, loitering, harassment and intimidation of pedestrians and customers, public urination, drug dealing, prostitution, assault and even murder. These specific grievances represent more general quality-of-life, public health and safety problems that feed into the economic and social deterioration of an area. For example, safety issues, like drug dealing and stealing, raise local business operating expenses and create a poor business environment.

Increased competition between many bars and bottle stores in an area may encourage cost-cutting and irresponsible management. This study showed that customer visits to liquor stores or bars often did not involve other retail shopping or consumer activity. High numbers of alcohol outlets may be displacing a retail mix that would benefit other businesses.

Many councils want to develop vibrant entertainment areas that attract tourists as well as local residents. Restaurants, bars and bottle stores provide jobs and other economic benefits, and increasing numbers of licensed premises may be thought desirable for the community. Concentrating alcohol-related problems in one area – but away from residential zones – may even seem to be a good idea from a policing perspective.

This review of research shows that concentrations of alcohol outlets can in fact increase the local problems to be dealt with. Local governments may wish to give careful consideration to the location and density of bars and bottle stores and to the role that these kinds of business play in the retail mix of their city centres.

References

Gruenewald, P.J., L. Remer and R.Lipton (2002) Evaluating the alcohol environment: Community geography and alcohol problems. Alcohol Research and Health 26(1): 42-48.

Reynolds, R.I., H.D. Holder and P.J.Gruenewald (1997) Community prevention and alcohol retail access. Addiction 92: S261-S269.

Watts and Rabow cited in Alaniz, ML. (1998) Alcohol availability and targeted advertising in racial/ethnic minority communities. Alcohol Health and Research World. 22(4): 286-289.

Gruenewald, P.J., A.B. Millar and P. Roeper (1996) Access to alcohol. Alcohol Health and Research World 20(4): 244-251.

Gorman, D.M., P.W. Speer, P.J.Gruenewald and E.W. Labouvie (2001) Spatial dynamics of alcohol availability, neighborhood structure and violent crime. Journal of Studies on Alcohol, 62(5): 628-637.

Scribner, R., D. Cohen, S. Kaplanand S.H. Allen (1999) Alcohol availability and homicide in New Orleans: Conceptual considerations for small area analysis of the effect of alcohol outlet density. Journal of Studies on Alcohol 60(3): 310-317.

Scribner, R.A., D.P. MacKinnon andJ.H. Dwyer (1995) The risk of assaultive violence and alcohol availability in Los Angeles County. American Journal of Public Health. 85(3): 335-340; Gruenewald, Millarand Roeper (1996); Alaniz (1998). Gorman et al. (2001).

Scribner, R., D. Cohen and W. Fisher (2000) Evidence of a structural effect for alcohol outlet density: A multilevel analysis. Alcoholism: Clinical and Experimental Research. 24(2): 188- 195.

Scribner, Cohen and Fisher (2000).Skog, O-J. (1985) The collectivity of drinking culture: A theory of the distribution of alcohol consumption. British Journal of Addiction 80: 83-99; Paton-Simpson, G. (2001) Socially obligatory drinking: A sociological analysis of norms governing minimum drinking levels. Contemporary Drug Problems 28: 133-177.

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Babor, T. et al. (eds) (2003) Alcohol: No Ordinary Commodity. Research and Public Health. Oxford University Press/World Health Organization, Geneva. August. Chapter 10; Alaniz (1998).

Gorman et al. (2001).

Parker, R. Nash and R.S. Cartmill (1998) Alcohol and homicide in the US: Or one reason why US rates of violence may be going down. Journal of Criminal Law and Criminology. 88(4): 1369-1398.

Schribner, Cohen, Kaplan and Allen (1999).

Gruenewald, Millar and Roeper (1996) Lipton, R. and P. Gruenewald (2001) The spatial dynamics of violence and alcohol outlets. Journal of Studies in Alcohol 63: 187-195.

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Maxwell, A. and D. Immergluck (1997) Liquorlining: Liquor store concentration and community development in lower-income Cook County neighborhoods. Woodstock Institute, Chicago.

Schribner, Cohen, Kaplan and Allen (1999); Alaniz (1998).

Parker and Cartmill (1998).

Maxwell and Immergluck (1997)

Note: The work on which these articles are based was funded by the New Zealand Ministry of Health as part of a project on Planning for the Sale of Alcohol. A research and policy review and an issues paper from this project are available on www.ndp.govt.nz under Alcohol.