As of January 1, 2003, it became illegal to sell alcohol to intoxicated persons in 47 states and the District of Columbia. Yet the practice not only continues, it is common. A new study differentiates among the work experience of managers of bars and restaurants, types of liquor licenses, and policies and practices in order to tease out the differences among those establishments that sell, or do not, to pseudo-intoxicated customers.
Results are published in the July issue of Alcoholism: Clinical & Experimental Research.
"Alcohol consumption is associated with many problems, including traffic crashes, crime, and violence," said Kathleen M. Lenk, research coordinator with the Alcohol Epidemiology Program at the University of Minnesota and corresponding author for the study.
"At least 85,000 Americans die each year from alcohol-related causes, making it the third leading actual cause of death in the United States," added Carol L. Cannon, associate research scientist at the Pacific Institute for Research and Evaluation. "Devastating human and social costs are compounded by economic consequences. In 1998, the total monetary cost of alcohol-attributable consequences – including health care costs, productivity losses, and alcohol-related crime costs – was estimated to be $185 billion."
Furthermore, said Cannon, alcohol-related problems are often associated with the over-consumption of alcohol in retail establishments. "For example, studies suggest that up to 50 percent of drinking and driving incidents begin in alcohol retail establishments," she said, "and that bars are 'hot spots' for crime and violence … 10 percent of all violent incidents occur on these premises." For these reasons, she said, curtailing sales to intoxicated persons can have a significant impact on alcohol-related harm.
Researchers hired professional actors to feign intoxication while attempting to purchase alcohol at 231 Midwestern bars and restaurants (on-premise sites). The researchers also conducted a telephone survey of the owners and/or managers of each establishment to determine how their policies/practices were associated with the likelihood that the bars and restaurants would sell alcohol to intoxicated patrons.
Pseudo-intoxicated customers were able to purchase alcohol in 65 percent of their attempts. Both Lenk and Cannon said that this falls within the range found in previous studies, between 58 and 89 percent of the time.
Certain types of establishments were either more or less likely to sell to the actors. First, those establishments with full liquor licenses – as opposed to only beer- or wine-sales licenses – were less likely to sell to intoxicated patrons. "Nonetheless, their sales rates were still high, 59 percent, and this should not be ignored," said Lenk. "Bars and restaurants that just sell beer and/or wine, but not hard liquor, may not regularly encounter obviously intoxicated patrons, and so may not be as aware of the need to refuse to serve this type of patron."
"It might be worthwhile for alcoholic beverage-control agencies to focus educational efforts on establishments without full-liquor licenses," added Cannon. "As indicated by the authors, their staff training may be less rigorous when it comes to selling to the obviously intoxicated."
Second, establishments with managers who had at least one year of employment were more likely to sell to apparently intoxicated patrons. "One explanation is that management may initially be more cautious of following alcohol sales laws," said Lenk, "and then perhaps become somewhat lax once they are comfortable. Servers may also be more cautious in following rules with a new manager because it is unknown how he or she will react to selling alcohol to intoxicated patrons."
Third, establishments that held staff meetings at least once a month were less likely to sell to apparently intoxicated patrons. "We basically predicted this relationship," said Lenk, "given that our manager-training program recommends frequent staff meetings as a strategy to decrease illegal alcohol sales."
Collectively speaking, said Cannon, these findings have three major implications. "Those establishments serving only wine and beer may benefit from additional education and training on state alcohol policies," she said. "Next, there may be a need for 'refresher' courses in alcohol policies to help longer-term managers maintain their compliance with these state laws. Finally, we can see the important effect of regular staff meetings on compliance with those state policies prohibiting sales to intoxicated persons."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Propensity of Alcohol Establishments to Sell to Obviously Intoxicated Patrons," were Traci L. Toomey and Darin J. Erickson of the Division of Epidemiology and Community Health in the School of Public Health at the University of Minnesota. The study was funded by the National Institute on Alcohol Abuse and Alcoholism.
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