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Key Results: Alcohol Retail Policy
Citations Listed in Key Results
- In the early 1990s, licensed establishments such as bars, restaurants, and convenience stores routinely sold alcohol to underage youth. While underage sales have declined, they are still relatively common, prompting interest in more intensive community-wide interventions to address the problem.
Studies conducted in the early 1990s found that young people under age 21 could easily purchase alcohol from bars, restaurants, convenience stores and grocery stores without showing any age identification. Sales rates to underage youth ranged from 45% to 97% (Forster et al. 1994, 1995; Preusser and Williams 1992; OLeary, Gorman, and Speer, 1994; Schofield, Weeks, and Sanson-Fisher. 1994; Vaucher et al. 1995).
The successful effort in the 1980s to raise the minimum legal drinking age (MLDA) to 21 across the country was intended to reduce youth alcohol use. But while higher a MLDA has been linked to a reduction in drinking and traffic accidents among young adults (Wagenaar and Toomey 2002), poor enforcement appears to have blunted its effect on deterring alcohol sales to underage drinkers. A study conducted during the early 1990s found that there was little enforcement of the MLDA across the U.S. and when there was enforcement, it mainly targeted underage purchasers rather than adult sellers (Wagenaar and Wolfson 1994).
During the mid to late 1990s, tens of millions of dollars was given to states and communities by the Robert Wood Johnson Foundation and the U.S. Department of Justice Office for Juvenile Justice and Delinquency Prevention to fund a variety of initiatives to curb underage alcohol use, including more intensive action to prevent sales to underage drinkers. While previous efforts directed at sales had targeted the youth purchasers, these funds supported enforcement focused primarily on sellers. Despite this change in tactics, more recent studies showed that youth can still purchase alcohol 26-39% of the time (Britt et al. 2006; Freisthler et al. 2003; Paschall et al. 2007).
Recent assessments suggest that while progress is being made, further reductions in youth alcohol use and related problems could be achieved through community-wide interventions that focus broadly on reducing illegal sales and limiting access from other sources as well (Wagenaar et al. 2000).
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- Research shows that intoxicated customers can easily purchase alcohol from licensed establishments even though such sales are illegal in most states.
Although it is illegal in most states to sell alcohol to individuals who appear obviously intoxicated, researchers have found such sales are very likely.
Studies probing this issue usually involve employing actors who pretend to be inebriated while attempting to purchase alcohol. They have found that individuals who appeared to be intoxicated were able to buy alcohol from 58% to 85% of the time (Freisthler et al. 2003; Lenk, Toomey, and Erickson, 2006; Toomey et al. 1999, 2004).
Servers assessed to be under age 30 are more likely to sell alcohol to intoxicated customers than older servers (Freisthler et al. 2003; Toomey et al. 2004). Also, liquor stores and convenience stores may be more likely to sell to obviously intoxicated customers than bars and restaurants. In addition, sales to intoxicated customers appear to be more common at establishments located near other alcohol retailers or in areas of high population density (Toomey et al. 2004; Freisthler et al. 2003).
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- Server training is often used to increase responsible sales, but by themselves, server training programs are unlikely to prevent sales to minors or intoxicated customers. This shortcoming may be due to the fact that that program quality is highly variable.
Server training seeks to improve responsible sales by showing bartenders and other servers the proper way to conduct age identification checks, recognize intoxicated customers, refuse alcohol service, slow down alcohol service, and promote alcohol-free beverages.
Early studies assessing server training programs suggested that training - especially programs that also included training for managers of establishments--may improve servers attitudes toward responsible alcohol service, increase offers of non-alcoholic beverages, and reduce customer intoxication levels (Howard-Pitney et al. 1991; McKnight 1991; Saltz 1987). Other studies, however, have found that server training programs may be unlikely to prevent illegal alcohol sales to underage youth or obviously intoxicated patrons (Howard-Pitney et al. 1991; McKnight 1991).
An in-depth assessment of 22 server training programs showed that the quality of server training varied greatly, with most failing to provide information on how to prevent sales to underage youth or offer effective methods that would help servers deny alcohol sales to certain customers (Toomey et al. 1998). None of the existing programs being implemented outside of research projects focused on training owners and managers of alcohol establishments to encourage implementation of establishment alcohol policies.
Including owners and managers in training could be important, given research indicating that employees can feel pressure - and even fear for their jobs - if they dont serve all patrons regardless of age or intoxication. (Gehan et al. 1999). Thus, to promote responsible service of alcohol, management practices within establishments may need to be altered to reinforce server training (Saltz 1987). In focus group discussions, alcohol servers indicated that they would appreciate management providing written alcohol policies in their establishment that contained clear guidelines for responsible alcohol service (Gehan et al. 1999).
Toomey and colleagues (2001) developed an intensive training program "Alcohol Risk Management (ARM)" for owners and managers of alcohol establishments to promote establishment-specific alcohol control policies. However, subsequent testing of the program found it had no effect on reducing sales to underage drinkers, and although it might reduce sales to intoxicated customers, the effect appeared to be short-lived. (Toomey et al 2008b).
There is evidence that a strong, state-wide policy mandating quality server training may create enough changes in service to reduce fatal traffic accidents. Following enactment of Oregons responsible beverage service law, traffic fatalities were significantly reduced (Holder and Wagenaar 1994). However, most states that have enacted laws mandating or promoting responsible beverage service training programs do not have policies that are as strong as Oregons and are unlikely to be effective in preventing alcohol-related problems (Mosher et al. 2002).
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- Comprehensive compliance campaigns by law enforcement can prevent alcohol sales to minors but may not be as feasible for preventing sales to obviously intoxicated customers.
There is a growing body of evidence that compliance checks - in which underage individuals working with law enforcement agents attempt to purchase alcohol - can prevent illegal alcohol sales to underage youth (Grube 1997; Preusser, Williams, and Weinstein. 1994; Scribner and Cohen 2001). A review of research findings by the U.S. Centers for Disease Control and Prevention Task Force on Community Preventive Services concluded that there is sufficient evidence to recommend "enhanced enforcement" to prevent underage alcohol sales (http://www.thecommunityguide.org/alcohol/default.htm).
One issue concerns how extensive and frequent compliance checks need to occur in order to sustain their effectiveness. A study of 20 Midwestern communities reported that in the specific bars or restaurants targeted for enforcement action, the likelihood of sales to minors dropped 17% immediately after the compliance checks. But three months later, the reduction in sales to minors was only 8% (Wagenaar, Toomey, and Erickson 2005).
The same immediate 17 percent drop in underage sales also was observed in liquor stores, convenience stores, and grocery stores that were checked for compliance, but the deterrence effect completely disappeared after three months. Moreover, the study found that the effects of the enforcement actions were confined to the establishments checked. They did not influence the behavior of community alcohol retailers in general.
Although compliance checks can prevent illegal alcohol sales to underage youth, use of this type of enforcement campaign is not as feasible to prevent illegal alcohol sales to obviously intoxicated individuals. Law enforcement agencies could face liability issues if they hire an individual to become intoxicated for the purposes of conducting compliance checks and then that individual is harmed in any way. Communities are still trying to identify efficient and effective enforcement methods to prevent these types of illegal alcohol sales.
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- Illegal alcohol sales to both underage and obviously intoxicated individuals are very likely at community festivals, and there is a need to identify effective strategies for dealing with this problem.
Community festivals are events that often secure temporary licenses to sell alcohol. These events involve the assembly of a large number of people who consume large amounts of alcohol in a concentrated area, increasing the risk of fights, traffic crashes around the events, and vandalism of local property.
Community festivals are common throughout the United States. During one year over 1,000 festivals could occur in just one state. A study of 50 Midwestern community festivals found that alcohol was sold in 50 percent of purchase attempts made by individuals who appeared to be under 21 and did not present age identification. Meanwhile, individuals who appeared intoxicated were able to buy alcohol in 89% of their purchase attempts (Toomey, Patrek, and Erickson 2005).
Likelihood of sales to underage youth was higher at community festivals than at bars, restaurants, convenience stores, and grocery stores during the same time period. In fact, the underage sales rate at community festivals was comparable to the high sales rate to minors (since significantly reduced) at licensed establishments during the early 1990s (Forster et al. 1994, 1995; Preusser and Williams 1992; OLeary, Gorman, and Speer, 1994; Schofield, Weeks, and Sanson-Fisher. 1994; Vaucher et al. 1995); however, we do not know how frequently underage youth buy alcohol at festivals versus at licensed establishments. Festival sales to obviously intoxicated patrons were comparable to such sales at conventional establishments during the same period. (Freisthler et al. 2003; Lenk, Toomey, and Erickson, 2006; Toomey et al. 1999, 2004).
A survey of festival planners in the Midwest found approximately half of the festivals require server training on how to responsibly sell alcohol. Sixty percent have alcohol-free areas and 66% restrict alcohol sales and use to specific areas of the festival. The number of drinks sold per person per sale was only restricted at 29% of the festivals, though 78% do prevent attendees from leaving the event with alcohol (Toomey et al. 1999).
More research is available to guide interventions targeting illegal alcohol sales at licensed establishments than at community festivals. One demonstration project was recently conducted to assess whether either a training program or a community organizing campaign could be effective in influencing alcohol control policies at community festivals and reduce the likelihood of illegal alcohol sales to underage and obviously intoxicated patrons (Toomey et al. 2006). However, while the project produced changes to festival alcohol policies, no change was observed in the likelihood of illegal alcohol sales at festivals following either intervention.
Also, the interventions did not prompt law enforcement to increase compliance checks at festivals. Less than a quarter of surveyed law enforcement agencies reported conducting compliance checks at festivals (Toomey et al. 2006). Research involving compliance checks at licensed establishments such as bars or retail stores shows that intensifying enforcement can curb underage sales (Grube 1997; Wagenaar, Toomey, and Erickson, 2005).
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- Illegal alcohol sales to both underage and obviously intoxicated individuals are also very likely at professional sport stadiums, especially in the stands.
Media stories across the U.S. have publicized problems caused by sport fans who have consumed alcohol to excess (McDonald 2004; Warner 2005). Alcohol is readily available at many sport stadiums across the U.S. Given that over 130 million fans attend professional hockey, football, baseball, and basketball events each year, risks of alcohol-related problems are high if even a small portion of these fans consume too much alcohol. Illegal alcohol sales to underage youth and obviously intoxicated fans may increase the likelihood of fans drinking alcohol to excess and causing problems.
Likelihood of illegal alcohol sales to obviously intoxicated patrons is very high at professional sport stadiums. A study of 16 professional hockey, football, baseball, and basketball stadiums located in five states, found that stadiums would sell alcohol to individuals who appeared intoxicated 74% of the time (Toomey et al. 2008a). Although sales to individuals who appeared intoxicated was very high at stadium booths, the odds of these alcohol sales were almost three times higher in the stands. Alcohol servers in the stands were less likely to notice the apparent intoxication level of these buyers.
Likelihood of alcohol sales to underage youth is less likely at these stadiums. However, the same study found that individuals judged to look under age 21 were able to purchase alcohol without showing age identification nearly one out of every five times. Again, sellers in the stands were almost three times more likely to sell alcohol to these young-appearing individuals than sellers in the stadium booths. Sellers in the stands were also much less likely to ask for age identification.
Although it is important to prevent underage youth from obtaining alcohol from any source, we do not know how many youth are purchasing alcohol at professional sport stadiums. If few youth are purchasing alcohol at sporting events, communities may find that resources can be better used to prevent sales to obviously intoxicated fans at these events. However, currently there is no research indicating which interventions would be most effective in preventing either type of illegal alcohol sales at these stadiums.
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- Increasing the number of days of alcohol sales may increase traffic crashes.
An important research question is whether alcohol-related problems are influenced by the number of days alcohol is sold. Most of the research focusing on this question has focused on effects of lifting bans on Sunday alcohol sales; Sunday sales have been restricted in some states as part of the blue laws. A SAPRP-funded study of New Mexicos 1995 repeal of its ban on Sunday sales at liquor stores or "off-premise" establishments found that in the wake of the decision, alcohol-related traffic crashes on Sundays increased by 29% and alcohol-related traffic fatalities on Sundays went up by 42%. No changes in alcohol-related traffic crashes were observed on other days of the week (McMillan and Lapham 2006).
Communities in New Mexico had the option of voting to maintain a local ban on Sunday sales. The three communities that voted to keep the ban had the lowest increase in traffic crashes, suggesting that the local option allowed individual communities to avoid large increases in alcohol-related accidents associated with the repeal (McMillan, Hanson, and Lapham, 2007).
Several studies have examined the impact in other countries of repealing bans on Sunday sales. They also documented the repeals was followed by an increase in traffic accidents and other alcohol related problems on Sundays. (Northridge, McMurray, and Lawson, 1986; Smith 1978, 1988).
As of January 2007, 15 states in the U.S. had bans on Sunday alcohol sales. Click here for more. A review of research findings by the U.S. Centers for Disease Control and Prevention Task Force on Community Preventive Services concluded that there is strong evidence to "recommend maintaining existing limits on the days on which alcoholic beverages are sold, as one strategy for the prevention of excessive alcohol consumption and related harms." (http://www.thecommunityguide.org/alcohol/limitingsale.html).
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- A higher density of alcohol establishments is associated with more crime.
Liquor stores are often concentrated in poorer neighborhoods with large minority populations (Gorman and Speer 1997), and bars are often concentrated around college campuses (Wechsler et al. 2002).
At least 14 studies have found that a higher density of alcohol establishments within neighborhoods, blocks, or census tracts is associated with higher levels of crime, including violent crimes and property crimes (e.g., Britt et al. 2005; Gyimah-Brempong and Racine 2006; Gorman Speer, and Gruenewald, 2001, Zhu, Gorman, and Horel, 2006). But different types of establishments may contribute differently to drinking and alcohol-related problems (Gorman, Zhu, and Horel, 2005; Gruenewald et al. 2006; Scribner et al. 1999; Smart and Mann 1998; Smith 1989, 1992).
For example, an over-concentration of bars and nightclubs may contribute to traffic crashes, while an over-concentration of liquor stores in particular neighborhoods may contribute to crime, drug dealing, and other social disorder (Speer et al. 1998). A review of research findings by the U.S. Centers for Disease Control and Prevention Task Force on Community Preventive Services concluded that there is sufficient evidence to recommend limiting the density of alcohol establishments to prevent excessive alcohol consumption and related harms (http://www.thecommunityguide.org/alcohol/default.htm).
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- Selling alcohol via drive-up windows may increase availability and drunk driving, but the effect of banning this easy access is unclear.
Some states allow establishments to sell alcohol for off-site consumption at drive-up windows similar to what one would find at fast food restaurants. In one study conducted in New Mexico, researchers found that the odds of drinking in a car prior to arrest for drunk driving was 67% higher for offenders who had purchased alcohol at a drive-up window than offenders who had purchased alcohol at other types of off-premise establishments (Lewis, Lapham, and Skipper. 1998).
A study conducted in the wake of New Mexicos 1998 decision to end drive-up window sales did not find a significant association between an end to the sales and a decrease in alcohol-related traffic accidents. However, only a small percentage of establishments offered drive-up sales. So while people who purchased alcohol from drive-up windows were more likely to be arrested for drunk driving, the ban ultimately did not affect a sufficiently large portion of the alcohol-purchasing public to have a state-wide impact on traffic accidents (Lapham et al. 2004).
Another limitation of the New Mexico ban is that 26% of the establishments that had sold alcohol through a drive-up window switched to "step-in" sales that allowed customers to quickly purchase alcohol right inside the door while leaving their cars running (Lapham and Skipper 2004).
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