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CORK Bibliography: Bars and Alcohol Sale Outlets

38 citations. January 2010 to present

Prepared: March 2011

Anderson T; Daly K; Rapp L. Clubbing masculinities and crime: A qualitative study of Philadelphia nightclub scenes. Feminist Criminology 4(4): 302-332, 2009. (100 refs.)

The purpose of our article is to explore the relationship between masculinities and crime within the hip-hop (HH) and electronic dance music (EDM) nightclub scenes in Philadelphia. Given extant theory and research showing gender is a situated performance, the social context of the nightclub setting offers an important opportunity to contribute to the ever-growing masculinities and crime literature because it is an understudied setting populated by atypical offenders. Direct observation of 33 club events and interviews with 24 male clubbers yielded three important patterns: (a) Men with consistently high masculinities (hypermasculine types) reported the most frequent involvement in nightclub crime, (b) men with consistently low masculinity scores reported the least involvement, and (c) men with variable masculinity scores put on a more hypermasculine identity while clubbing, leading them to engage in nightclub crime. Contextual factors, such as excessive alcohol use, heightened sexuality, competitiveness, and commercialism, explain this more nuanced relationship between masculinity and crime.

Antin TMJ; Moore RS; Lee JP; Satterlund TD. Law in practice: Obstacles to a smokefree workplace policy in bars serving Asian patrons. Journal of Immigrant and Minority Health 12(2): 221-227, 2010. (32 refs.)

The California smokefree workplace ordinance (AB13) has been well-received, even in bars where deeply established traditions of smoking may exist. However, a closer investigation of bars where indoor smoking persists revealed that bar workers in some ethnic minority communities continue to be exposed to secondhand smoke in their workplaces. To identify sociocultural factors that may impede the adoption of AB13, the researchers conducted 150 observations and 29 patron and staff interviews in 50 California bars serving Asian patrons in Los Angeles and San Francisco counties. Observers witnessed indoor smoking in 82% of the bars. Interviews revealed that social relationships, social interactions, and a tendency to avoid confrontation complicated the positive reception of AB13 within these bars. Accounting for sociocultural factors provides a nuanced understanding of the challenges involved in implementing tobacco control policy in such diverse settings and may allow for culturally appropriate tobacco policy development and implementation in other jurisdictions.

Barnett TE; Curbow BA; Soule EK; Tomar SL; Thombs DL. Carbon monoxide levels among patrons of hookah cafes. American Journal of Preventive Medicine 40(3): 324-328, 2011. (27 refs.)

Background: Individuals who use a hookah (water pipe) as a method of tobacco smoking are exposed to high levels of carbon monoxide (CO). Assessing hookah use in one of the venues of its use (hookah bars) will aid the understanding of the toxins and exposure for the user. In Florida, smoking is prohibited in public places under the Florida Clean Indoor Act but permitted in establishments that have less than 10% gross revenue from food. Purpose: To assess the CO level of hookah cafe patrons, using traditional bar patrons as a comparison. Methods: After IRB approval, a nighttime field study of patrons (aged > 18 years) exiting hookah cafes and traditional bars in 2009 was conducted, using sidewalk locations immediately outside these establishments in a campus community. As hookah cafes and bars are typically entered and exited in groups, every other group of people exiting the establishment was approached. For comparison purposes, the sample collected was similar in number, 173 hookah cafe and 198 traditional bar participants. Results: Results from analysis conducted in 2010 indicate that patrons of hookah cafes had significantly higher CO levels (mean = 30.8 parts per million [ppm]) compared to patrons of traditional bars (mean = 8.9 ppm). Respondents who indicate no cigarette use in the past month but had visited a hookah cafe still demonstrated significantly higher CO values (mean = 28.5 ppm) compared to those exiting traditional bars (mean = 8.0 ppm). Current cigarette smokers also produced significantly more CO if exiting a hookah cafe (mean = 34.7 ppm) compared to a traditional bar (mean = 13.3 ppm). Conclusions: CO levels are higher for patrons of hookah cafes, for both current and non-cigarette smokers. Although users report that they perceive hookah to be less harmful than cigarettes, the greater CO exposure for hookah users that was observed in this study is not consistent with that perception.

Bellis MA; Hughes K; Quigg Z; Morleo M; Jarman I; Lisboa P. Cross-sectional measures and modelled estimates of blood alcohol levels in UK nightlife and their relationships with drinking behaviours and observed signs of inebriation. Substance Abuse Treatment, Prevention and Policy 5: article 5, 2010. (46 refs.)

Background: Management of nightlife in UK cities focuses on creating safe places for individuals to drink. Little is known about intoxication levels as measuring total alcohol consumption on nights out is complicated by early evening interviews missing subsequent consumption and later interviews risking individuals being too drunk to recall consumption or participate at all. Here we assess mixed survey and modelling techniques as a methodological approach to examining these issues. Methods: Interviews with a cross sectional sample of nightlife patrons (n = 214) recruited at different locations in three cities established alcohol consumption patterns up to the point of interview, self-assessed drunkenness and intended drinking patterns throughout the remaining night out. Researchers observed individuals' behaviours to independently assess drunkenness. Breath alcohol tests and general linear modelling were used to model blood alcohol levels at participants' expected time of leaving nightlife settings. Results: At interview 49.53% of individuals regarded themselves as drunk and 79.43% intended to consume more alcohol before returning home, with around one in ten individuals (15.38% males; 4.35% females) intending to consume >40 units (equal to 400 mls of pure alcohol). Self-assessed drunkenness, researcher observed measures of sobriety and blood alcohol levels all correlated well. Modelled estimates for blood alcohol at time of going home suggested that 71.68% of males would be over 0.15% BAC (gms alcohol/100 mls blood). Higher blood alcohol levels were related to drinking later into the night. Conclusions: UK nightlife has used substantive health and judicial resources with the aim of creating safer and later drinking environments. Survey and modelling techniques together can help characterise the condition of drinkers when using and leaving these settings. Here such methods identified patrons as routinely getting drunk, with risks of drunkenness increasing over later nights. Without preventing drunkenness and sales to intoxicated individuals, extended drinking hours can simply act as havens for drunks. A public health approach to nightlife is needed to better understand and take into account the chronic effects of drunkenness, the damages arising after drunk individuals leave city centres and the costs of people avoiding drunken city centres at night.

Bitler MP; Carpenter CS; Zavodny M. Effects of venue-specific state clean indoor air laws on smoking-related outcomes. Health Economics 19(12): 1425-1440, 2010. (21 refs.)

A large literature has documented relationships between state clean indoor air laws (SCIALs) and smoking-related outcomes in the United States. These laws vary within states over time and across venues such as schools, government buildings, and bars. Few studies, however, have evaluated whether the effects of SCIALs are plausibly concentrated among workers who should have been directly affected because they worked at locations covered by the venue-specific restrictions. We fill this gap in the literature using data on private sector workers, government employees, school workers, eating and drinking place workers, and bartenders from the 1992-2007 Tobacco Use Supplements to the Current Population Survey. Our quasiexperimental models indicate robust effects of SCIALs restricting smoking in bars: these laws significantly increased the presence of workplace smoking restrictions as reported by bartenders and reduced the fraction of bartenders who smoke. We do not, however, find that SCIALs in private workplaces, government workplaces, schools, or restaurants increased the presence of workplace smoking restrictions among groups of workers working in venues covered by these laws. This suggests that the smoking reductions associated with SCIALs in previous research are unlikely to have been directly caused by effects of workplace smoking restrictions on workers.

Brady M. On- and off-premise drinking choices among Indigenous Australians: The influence of socio-spatial factors. (editorial). Drug and Alcohol Review 29(4): 446-451, 2010. (52 refs.)

Braverman MT; Aaro LE; Bontempo DE; Hetland J. Bar and restaurant workers' attitudes towards Norway's comprehensive smoking ban: A growth curve analysis. Tobacco Control 19(3): 240-247, 2010. (33 refs.)

Background: Norway passed legislation banning smoking in restaurants, bars and other public spaces in 2004. This study tracks changes in hospitality workers' attitudes towards Norway's ban over three time points, using growth modelling analysis to examine predictors of attitude change. Methods: Participants were a national sample of 1525 bar and restaurant workers. Surveys were conducted, by phone or internet, one month before the ban's implementation and at 4 and 12 months thereafter. Exploratory principal components analysis of nine survey items revealed one primary attitude component. A latent growth model was fitted to the data to examine trajectories of attitude change and individual differences in rate of change. Results: Respondents supported the ban before implementation and increased support at 4 months (p=0.021) and again at 12 months (p=0.001). Concern for one's job followed a quadratic trend, increasing at 4 months and decreasing at 12 months (p<0.001). All demographic categories were associated with attitude increase; rate of increase was greater for females than males. Two within-person variables -- change in smoking status and change in job concern -- strongly predicted (p<0.001) respondents' deviations from their predicted group trajectories, explaining over 70% of residual between-person slope variance. Conclusions: Norway's hospitality workers increased their support of the ban over its first year. The strong influence of the within-person variables leads to two primary policy recommendations. First, support should be provided to assist cessation efforts and prevent relapse. Second, informational campaigns should inform hospitality workers about evidence that smoking bans are not economic threats to the industry.

Brennan E; Cameron M; Warne C; Durkin S; Borland R; Travers MJ et al. Secondhand smoke drift: Examining the influence of indoor smoking bans on indoor and outdoor air quality at pubs and bars. Nicotine & Tobacco Research 12(3): 271-277, 2010. (31 refs.)

This study aimed to examine the influence of indoor smoking bans on indoor and outdoor air quality at pubs and bars and to assess whether secondhand tobacco smoke (SHS) drifts from outdoor smoking areas to adjacent indoor areas. Data were covertly collected from a convenience sample of 19 pubs and bars that had at least 1 indoor area with an adjacent semi-enclosed outdoor eating/drinking area. Using TSI SidePak Personal Aerosol Monitors, concentrations of SHS (PM2.5) were measured concurrently in indoor and outdoor areas before and after implementation of the indoor smoking ban. Information was collected about the number of patrons and lit cigarettes and about the enclosure of outdoor areas. Indoor PM2.5 concentrations reduced by 65.5% from pre-ban to post-ban (95% CI 32.6%-82.3%, p = .004). Outdoor exposure to PM2.5 also reduced from pre-ban to post-ban by 38.8% (95% CI 3.2%-61.3%, p = .037). At post-ban, indoor concentrations of PM2.5 were positively associated with outdoor concentrations. After adjustment for covariates, a 100% increase in geometric mean (GM) outdoor PM2.5 was associated with a 36.1% (95% CI 2.4%-80.9%) increase in GM indoor PM2.5 exposure (p = .035). Indoor smoking bans are an effective means of improving indoor and outdoor air quality in pubs and bars, although the air quality of smoke-free indoor areas may be compromised by smoking in adjacent outdoor areas. These findings require consideration in efforts to ensure adequate protection of the health of employees and patrons.

Brister HA; Wetherill RR; Fromme K. Anticipated versus actual alcohol consumption during 21st birthday celebrations. Journal of Studies on Alcohol and Drugs 71(2): 180-183, 2010. (15 refs.)

Objective: The 21st birthday celebration is often associated with excessive alcohol consumption. The current study examined whether individuals consume more alcohol than anticipated during their celebration and whether situational factors contribute to prediction errors. Method: College students (N = 150; 50% female) who planned to drink during their 21st birthday celebration were contacted by telephone 1 week before their celebrations and asked about their birthday plans, including anticipated alcohol consumption. The week after the celebration, in-person semi-structured interviews and self-report measures were administered to obtain information about the 21st birthday celebration, including type and amount of alcohol consumed, pace of drinking, influential peer involvement, and engagement in 21st birthday traditions. Results: The majority of 21st birthday celebrants consumed more alcohol than they anticipated, with men showing greater prediction error than women. Situational factors were positively associated with the discrepancy between anticipated and actual alcohol consumption. Conclusions: Drinking shots, drinking at a fast pace, celebrating with influential peers, and engaging in 21st birthday traditions were associated with drinking more alcohol than anticipated during 21st birthday celebrations. Findings suggest future interventions that target situational factors could reduce excessive 21st birthday drinking.

Burkholder JD; Joines R; Cunningham-Hill M; Xu BW. Health and well-being factors associated with international business travel. Journal of Travel Medicine 17(5): 329-333, 2010. (14 refs.)

Background. International travel by US business travelers is continuing to increase with the globalization of the economy. The objective of this study was to determine if the frequency and duration of international business travel is associated with differences in travelers' health and well-being. This study expands our limited knowledge of the impact of long-haul travel on healthy lifestyle choices and traveler's perceptions of their health and well-being. Methods. 12,942 unique health risk appraisal (HRA) records of US employees of a multinational corporation were analyzed according to self-reported (objective and subjective) travel history and lifestyle habits. Results. Comparing 2,962 international travelers and 9,980 non-travelers, international business travel was significantly associated with a lower body mass index, lower blood pressure, excess alcohol consumption, sleep deprivation, and diminished confidence to keep up with the pace of work. Conclusions. This study demonstrated both positive and negative associations on the health risks and well-being of a large sample of US-based international business travelers from an US multinational company. This study identifies targeted areas for pretrip screening and counseling to proactively address potential negative effects of travel and may assist in the design of corporate travel health and employee assistance programs.

Cooper J; Borland R; Yong HH; Hyland A. Compliance and support for bans on smoking in licensed venues in Australia: Findings from the International Tobacco Control Four-Country Survey. Australian and New Zealand Journal of Public Health 34(4): 379-385, 2010. (31 refs.)

Objective: To examine attitudes towards and compliance with the recent Australian bans on smoking in licensed venues, and to explore effects on smoking behaviour. Methods: Three Australian states (Queensland, Tasmania and Western Australia) implemented a total ban on smoking in all enclosed licensed premises in 2006, and two others (Victoria and New South Wales) did so in mid-2007. We used data from smokers residing in these states for each of the six waves of the ITC-4 country survey (2002-2007; average n=1,694). Results: Consistent with the majority of international findings, observed compliance was reported by more than 90% of smokers from a pre-ban situation of indoor smoking being the norm. Attitudes became more positive in the year before the ban, but more than doubled in the year the bans were implemented. The associations found for the leading states were replicated by the lagging states a year later. We found no evidence for any increase in permitting smoking inside the home after the bans took effect. Further, we were unable to find any evidence of reductions in daily cigarette consumption or any increase in quitting activity due to the bans. Implications: These results add to a growing body of international research that suggests that smokers are readily able to comply with, and increasingly support, smoke-free bars, though the bans may have limited effect on their smoking habits.

Erazo M; Iglesias V; Droppelmann A; Acuna M; Peruga A; Breysse PN et al. Secondhand tobacco smoke in bars and restaurants in Santiago, Chile: Evaluation of partial smoking ban legislation in public places. Tobacco Control 19(6): 469-474, 2010. (38 refs.)

Objective: To compare air nicotine concentrations according to the smoking policy selected by bars/restaurants in Santiago, Chile before and after the enactment of partial smoking ban legislation in 2007 (establishments could be smoke free, have segregated (mixed) smoking and non-smoking areas, or allow smoking in all areas). Methods: The study measured air nicotine concentrations over 7 days to characterise secondhand smoke exposure in 30 bars/restaurants in 2008. Owner/manager interviews and physical inspections were conducted. Results: Median OR air nicotine concentrations measured in all venues were 4.38 (0.61-13.62) mu g/m(3). Air nicotine concentrations were higher in bars (median 7.22, IQR 2.48-15.64 mu g/m(3)) compared to restaurants (1.12, 0.15-9.22 mu g/m(3)). By smoking status, nicotine concentrations were higher in smoking venues (13.46, 5.31-16.87 mu g/m(3)), followed by smoking areas in mixed venues (9.22, 5.09-14.90 mu g/m(3)) and non-smoking areas in mixed venues (0.99, 0.19-1.27 mu g/m(3)). Air nicotine concentrations were markedly lower in smoke-free venues (0.12, 0.11-0.46 mu g/m(3)). After adjustment for differences in volume and ventilation, air nicotine concentrations were 3.2, 35.5 and 56.2 times higher in non-smoking areas in mixed venues, smoking areas in mixed venues and smoking venues, respectively, compared to smoke-free venues. Conclusions: Exposure to secondhand smoke remains high in bars and restaurants in Santiago, Chile. These findings demonstrate that the partial smoking ban legislation enacted in Chile in 2007 provides no protection to employees working in those venues. Enacting a comprehensive smoke-free legislation which protects all people from exposure to secondhand smoke in all public places and workplaces is urgently needed.

Fisher JC; Cook PA; Kapiga SH. Alcohol use before sex and HIV risk: Situational characteristics of protected and unprotected encounters among high-risk African Women. Sexually Transmitted Diseases 37(9): 571-578, 2010. (39 refs.)

Objectives: To compare the situational characteristics of protected and unprotected sexual encounters that involved alcohol use 2 hours prior with ones that did not. Methods: Data were collected between December 2002 and December 2005 as part of enrollment in a prospective cohort study designed to identify HIV seroconversion risk factors among women bar and hotel workers in Northern Tanzania. A total of 608 (37.3%) of the women who were inconsistent condom users were asked a set-matched questions concerning situational characteristics surrounding their last protected and unprotected sexual encounter including whether they had been drinking within 2 hours of sex. The associations between drinking 2 hours before sex (yes/no), condom use (protected/unprotected), and their interaction with the situational descriptors were examined with a 2 x 2 model for paired categorical data after controlling for time since the last type of encounter. Results: Condom failure was 5 times more likely if someone (woman, man, or both partners) had been drinking in advance of the encounter (OR, 5.19; 95% CI, 2.05-15.46) and was especially likely to occur if only the woman had been drinking before sex (OR, 14.05; 95% CI, 4.03-50.41). Alcohol use before sex was associated with sexual contacts where the woman was having sex with her partner for the first time, their relationship was casual or transitory or sex was transactional, the location was unfamiliar and less under her control, and the partner had been drinking or using drugs before having sex. Condom use was more frequent in precisely the same types of encounters. Interestingly, there were no significant interactions between alcohol use before sex and condom use, suggesting that drinking before sex and use of condom are distinct and not contingent risk factors. Conclusions: Alcohol use before sex is associated with an increased likelihood of condom failures and with high-risk sexual encounters, ones that have consistent situational characteristics regardless of whether condoms are used or not.

Forsyth AJM; Lennox JC. Gender differences in the choreography of alcohol-related violence: An observational study of aggression within licensed premises. Journal of Substance Use 15(2): 75-88, 2010. (54 refs.)

Aims: To examine patterns of gender involvement in violent incidents observed within licensed premises. Methods: Field observations were conducted in a sample of eight city centre nightclubs allowing alcohol-related aggressive incidents to be witnessed in their naturalistic setting. Results: Although most of those involved in aggressive incidents were males (108/171), many of the conflicts witnessed involved female combatants (36.8%). Additionally, female-to-female incidents were found to be as potentially injurious as those between males. Nevertheless, female-to-female and male-to-male conflicts did differ, in terms of the nature of the violence observed with, for example, female conflicts being less likely to involve an easily recognizable set pre-fight choreography. Conclusions: This research the challenges belief that female conflicts within licensed premises are less problematic than those involving males. These findings are discussed in terms of alcohol, masculinity, and harm reduction.

Gronkjaer M; Vinther-Larsen M; Curtis T; Gronbaek M; Norgaard M. Alcohol use in Denmark: A descriptive study on drinking contexts. Addiction Research & Theory 18(3): 359-370, 2010. (27 refs.)

Using data from the National Health and Morbidity Survey from 2005, we examined the contexts of alcohol use in Denmark in relation to gender and age. Among the 21,832 subjects invited to participate, 14,566 completed the survey. For the entire study population and restricted to heavy users (> 21 standard drinks per week for males; > 14 for females), we computed the prevalence of each age and gender group who indicated to drink alcohol in different drinking contexts. To compare the contexts for heavy use between age groups, we estimated prevalence ratios for each group compared to the 16-20-year-old age group, with adjustments for gender. Results showed that more than 68% of the study population drank alcohol in social contexts, such as at home with/visiting family and friends, or in party contexts. We found similar patterns among males and females; however, there was a predominance of males for drinking alcohol during work and leisure-times. The majority of heavy users also drank alcohol in social and party contexts. Among heavy users, drinking at home alone was eight times more prevalent among those aged 45-64 compared with those aged 16-20 years. We concluded that drinking contexts varied in relation to gender and age. Our findings provided useful insight into contexts for alcohol use in Denmark and will enable us to understand better some of the many aspects associated with alcohol use.

Gruenewald PJ; Johnson FW. Drinking, driving, and crashing: A traffic-flow model of alcohol-related motor vehicle accidents. Journal of Studies on Alcohol and Drugs 71(2): 237-248, 2010. (37 refs.)

Objective: This study examined the influence of on-premise alcohol-outlet densities and of drinking-driver densities on rates of alcohol-related motor vehicle crashes. A traffic-flow model is developed to represent geographic relationships between residential locations of drinking drivers, alcohol outlets, and alcohol-related motor vehicle crashes. Method: Cross-sectional and time-series cross-sectional spatial analyses were performed using data collected from 144 geographic units over 4 years. Data were obtained from archival and survey sources in six communities. Archival data were obtained within community areas and measured activities of either the resident population or persons visiting these communities. These data included local and highway traffic flow, locations of alcohol outlets, population density, network density of the local roadway system, and single-vehicle nighttime (SVN) crashes. Telephone-survey data obtained from residents of the communities were used to estimate the size of the resident drinking and driving population. Results: Cross-sectional analyses showed that effects relating on-premise densities to alcohol-related crashes were moderated by highway traffic flow. Depending on levels of highway traffic flow, 10% greater densities were related to 0% to 150% greater rates of SVN crashes. Time-series cross-sectional analyses showed that changes in the population pool of drinking drivers and on-premise densities interacted to increase SVN crash rates. Conclusions: A simple traffic-flow model can assess the effects of on-premise alcohol-outlet densities and of drinking-driver densities as they vary across communities to produce alcohol-related crashes. Analyses based on these models can usefully guide policy decisions on the siting of on-premise alcohol outlets.

Hahn R. Recommendations on maintaining limits on days and hours of sale of alcoholic beverages to prevent excessive alcohol consumption and related harms. American Journal of Preventive Medicine 39(6): 605-606, 2010. (5 refs.)

There are two major recommendation. The first focuses on limiting days on which alcoholic beverages are sold. The second focuses on limiting hours during which alcoholic beverages are sold. In respect to the first, there is strong evidence of effectiveness. Thus, the Task Force recommends maintaining existing limitations. Removal of limits on days of sale in off-premises settings results in small increases both in consumption of alcohol and in motor vehicle fatalities, there is a similar effect for on-premsise sales. Also, the Task Force recommends maintaining existing limits on the hours during which alcoholic beverages are sold at on-premises outlets as another strategy for preventing alcohol-related harms. Studies that examined increasing hours of sale by 2 or more hours found increases in vehicle crash injuries, emergency room admissions, and alcohol-related assault and injury. The Task Force found insufficient evidence to determine the effectiveness of increasing existing limits on hours of sale at off-premises outlets, because no studies were found that assessed such evidence.

Hahn R; Kuzara JL; Elder R; Brewer R; Chattopadhyay S; Fielding J et al. Effectiveness of policies restricting hours of alcohol sales in preventing excessive alcohol consumption and related harms. American Journal of Preventive Medicine 39(6): 590-604, 2010

Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the "Guide to Community Preventive Services" were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol consumption and related harms of laws and policies maintaining or reducing the days when alcoholic beverages may be sold. Outcomes assessed in 14 studies that met qualifying criteria were excessive alcohol consumption and alcohol-related harms, including motor vehicle injuries and deaths, violence-related and other injuries, and health conditions. Qualifying studies assessed the effects of changes in days of sale in both on-premises settings (at which alcoholic beverages are consumed where purchased) and off-premises settings (at which alcoholic beverages may not be consumed where purchased). Eleven studies assessed the effects of adding days of sale, and three studies assessed the effects of imposing a ban on sales on a given weekend day. The evidence from these studies indicated that increasing days of sale leads to increases in excessive alcohol consumption and alcohol-related harms and that reducing the number of days that alcoholic beverages are sold generally decreases alcohol-related harms. Based on these findings, when the expansion of days of sale is being considered, laws and policies maintaining the number of days of the week that alcoholic beverages are sold at on- and off-premises outlets in local, state, and national jurisdictions are effective public health strategies for preventing excessive alcohol consumption and related harms.

Jensen JA; Schillo BA; Moilanen MM; Lindgren BR; Murphy S; Carmella S et al. Tobacco smoke exposure in nonsmoking hospitality workers before and after a state smoking ban. Cancer Epidemiology, Biomarkers & Prevention 19(4): 1016-1021, 2010. (43 refs.)

Secondhand smoke exposure is estimated to account for 3,000 cancer deaths per year. Although several countries and states in the United States have passed comprehensive smoke-free laws to protect all employees, a significant number of workers are still not protected. The purpose of this study was to determine the effects of passing a comprehensive smoking ban that included bars and restaurants on biomarkers of nicotine and carcinogen exposure. The urines of nonsmoking employees (n = 24) of bars and restaurants that allowed smoking before the smoke-free law were analyzed before and after the law was passed in Minnesota. The results showed significant reductions in both total cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (free plus glucuronidated) after the ban was instituted. These results provide further support for the importance of protecting employees working in all venues.

Kahler CW; Spillane NS; Metrik J. Alcohol use and initial smoking lapses among heavy drinkers in smoking cessation treatment. Nicotine & Tobacco Research 12(7): 781-785, 2010. (31 refs.)

Introduction: This study examined alcohol use and its association with initial smoking lapses among heavy nondependent drinkers in smoking cessation treatment. Methods: Participants were 236 heavy drinking smokers in a randomized clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment. Results: Of the 178 participants who reported a smoking lapse, 41.5% lapsed when drinking alcohol. Those who had alcohol-involved lapses had significantly lower tobacco dependence severity and drank more drinks per week than those who had non-alcohol-involved lapses. The majority of alcohol-involved lapses were in a bar/restaurant, with other people, and when they were in a happy/good mood. In survival analyses with alcohol consumption as a time-varying covariate, moderate drinking days were associated with almost four times greater risk of smoking lapse than non-drinking days, and heavy drinking doubled the risk of lapsing compared with moderate drinking. Discussion: Results suggest that alcohol-related lapses are qualitatively different from lapses that do not involve alcohol. Furthermore, among heavy drinkers in cessation treatment, even moderate alcohol use is associated with increased risk of smoking, with heavy drinking further increasing the risk. Smoking cessation treatments for heavy alcohol drinkers should highlight the lapse risk associated with any alcohol consumption and with heavy drinking during a quit smoking attempt.

Kalichman SC. Social and structural HIV prevention in alcohol-serving establishments: Review of international interventions across populations. Alcohol Research & Health 33(3): 184-194, 2010. (48 refs.)

Alcohol use is associated with risks for sexually transmitted infections (STIs), including HIV/AIDS. People meet new sex partners at bars and other places where alcohol is served, and drinking venues facilitate STI transmission through sexual relationships within closely knit sexual networks. This paper reviews HIV prevention interventions conducted in bars, taverns, and informal drinking venues. Interventions designed to reduce HIV risk by altering the social interactions within drinking environments have demonstrated mixed results. Specifically, venue-based social influence models have reduced community-level risk in U.S. gay bars, but these effects have not generalized to gay bars elsewhere or to other populations. Few interventions have sought to alter the structural and physical environments of drinking places for HIV prevention. Uncontrolled program evaluations have reported promising approaches to bar-based structural interventions with gay men and female sex workers. Finally, a small number of studies have examined multilevel approaches that simultaneously intervene at both social and structural levels with encouraging results. Multilevel interventions that take environmental factors into account are needed to guide future HIV prevention efforts delivered within alcohol-serving.

King BA; Hyland AJ; Borland R; McNeill A; Cummings KM. Socioeconomic variation in the prevalence, introduction, retention, and removal of smoke-free policies among smokers: Findings from the International Tobacco Control (ITC) Four Country Survey. International Journal of Environmental Research and Public Health 8(2): 411-434, 2011. (39 refs.)

Introduction: Exposure to secondhand smoke causes premature death and disease in non-smokers and indoor smoke-free policies have become increasingly prevalent worldwide. Although socioeconomic disparities have been documented in tobacco use and cessation, the association between socioeconomic status (SES) and smoke-free policies is less well studied. Methods: Data were obtained from the 2006 and 2007 Waves of the International Tobacco Control Four Country Survey (ITC-4), a prospective study of nationally representative samples of smokers in Canada, the United States, the United Kingdom, and Australia. Telephone interviews were administered to 8,245 current and former adult smokers from October 2006 to February 2007. Between September 2007 and February 2008, 5,866 respondents were re-interviewed. Self-reported education and annual household income were used to create SES tertiles. Outcomes included the presence, introduction, and removal of smoke-free policies in homes, worksites, bars, and restaurants. Results: Smokers with high SES had increased odds of both having [OR: 1.54, 95% CI: 1.27-2.87] and introducing [OR: 1.49, 95% CI: 1.04-2.13] a total ban on smoking in the home compared to low SES smokers. Continuing smokers with high SES also had decreased odds of removing a total ban [OR: 0.44, 95% CI: 0.26-0.73]. No consistent association was observed between SES and the presence or introduction of bans in worksites, bars, or restaurants. Conclusions: The presence, introduction, and retention of smoke-free homes increases with increasing SES, but no consistent socioeconomic variation exists in the presence or introduction of total smoking bans in worksites, bars, or restaurants. Opportunities exist to reduce SES disparities in smoke-free homes, while the lack of socioeconomic differences in public workplace, bar, and restaurant smoke-free policies suggest these measures are now equitably distributed in these four countries.

Kypri K; Jones C; McElduff P; Barker D. Effects of restricting pub closing times on night-time assaults in an Australian city. Addiction 106(2): 303-310, 2011. (18 refs.)

Aims: In March 2008 the New South Wales judiciary restricted pub closing times to 3 a.m., and later 3.30 a.m., in the central business district (CBD) of Newcastle, Australia. We sought to determine whether the restriction reduced the incidence of assault. Design: Non-equivalent control group design with before and after observations. Setting: Newcastle, a city of 530 000 people. Participants: People apprehended for assault in the CBD and nearby Hamilton, an area with a similar night-time economy but where no restriction was imposed. Measurements: Police-recorded assaults in the CBD before and after the restriction were compared with those in Hamilton. Cases were assaults occurring from 10 p.m.-6 a.m. from January 2001-March 2008, with April 2008-September 2009 as the post-restriction period. We also examined changes in assault incidence by time of night. Negative binomial regression with time, area, time x area interaction terms and terms for secular trend and seasonal effects was used to analyse the data. Autocorrelation was examined using generalized estimating equations. Findings: In the CBD, recorded assaults fell from 99.0 per quarter before the restriction to 67.7 per quarter afterward [incidence rate ratio (IRR): 0.66, 95% confidence interval (CI): 0.55-0.80]. In the same periods in Hamilton, assault rates were 23.4 and 25.5 per quarter, respectively (IRR: 1.02, 95% CI: 0.79-1.31). The relative reduction attributable to the intervention was 37% (IRR = 0.63, 95% CI: 0.47-0.81) and approximately 33 assault incidents were prevented per quarter. Conclusion: This study indicates that a restriction in pub closing times to 3/3.30 a.m. in Newcastle, NSW, produced a large relative reduction in assault incidence of 37% in comparison to a control locality.

Li X; Li Q; Dong L; Sun B; Chen J; Jiang Y et al. Risk factors associated with smoking behaviour in recreational venues: Findings from the International Tobacco Control (ITC) China Survey. Tobacco Control 19(Supplement 2): i30, 2010. (48 refs.)

Objective: To explore the determinants of smoking behaviour in recreational venues and to provide scientific bases for establishing smoke-free measures applying to these locations. Methods: The International Tobacco Control (ITC) China Survey-a face-to-face cross-sectional survey of representative adult smokers from six cities ( Shenyang, Beijing, Shanghai, Guangzhou, Changsha and Yinchuan) was conducted between April and August 2006. A total of 4815 smokers were selected using multistage sampling methods, and final analyses were conducted on 2875 smokers who reported patronising recreational venues at least once in the last six months. Multivariate logistic regression models were used to identify factors influencing the smoking behaviour within recreational settings. Outcome measure: Whether a smoker reported smoking in recreational venues during the last 6 months. Results: 84% of subjects reported smoking in recreational venues. The following factors were significant predicators of smoking in recreational venues: absence of bans on smoking, support for non-bans, being aged 18-24 years, positive smoking-related attitudes, low number of health effects reported and not living in Beijing. Conclusions: The findings point to the importance of informing Chinese smokers about the active smoking and passive smoking harmfulness in both building support for smoke-free laws and in reducing smokers' desire to smoke within recreational venues. They also point to the importance of good enforcement of smoke-free laws when implemented. Such strategies could also serve to de-normalise smoking in China, a key strategy for reducing smoking in general.

Marin HA; Diaz-Toro E. The effect of the smoke-free workplace policy in the exposure to secondhand smoke in restaurants, pubs, and discos in San Juan, Puerto Rico26. Puerto Rico Health Sciences Journal 29(3, special issue): 279-285, 2010. (26 refs.)

Background: Tobacco use and the involuntary exposition to secondhand smoke (SHS) is one of the leading causes of all cancers in the world. The objective of this study was to assess the effect of the smoke-free workplace policy implemented in March of 2007 in Puerto Rico on the exposition to secondhand smoke in restaurants, pubs, and discos of the metropolitan area of San Juan, Puerto Rico. Methods: The study used a pre-post comparison design on a random sample of 55 establishments (32 restaurants and 23 pubs and discos) in the metropolitan area of San Juan, Puerto Rico. Measurements of indoor concentrations of fine particulate matter (PM) (2.5 mm diameter, PM2.5) were taken before and after the introduction of the law banning smoking using a Side Pak AM510 Personal Aerosol Monitor (TSI Company). Also, data on the number of smokers, number of customers, and establishment area was collected. Paired t-tests and linear regression analyses were used to test any statistically significant effect of the law. Results: After the smoking ban was implemented, restaurants experienced an 83.6% (p=0.013) reduction in the mean of PM 2.5 levels, from 0.169 to 0.028 mg/m(3), and pubs and discos experienced a 95.6% (p=0.004) reduction, from 0.626 to .028 mg/m(3). Conclusion: The implementation of the smoke-free workplace policy considerably reduced the exposition to 5115 of workers and customers in the restaurants, pubs, and discos of the metropolitan area of San Juan, Puerto Rico.

Moore SC; Brennan IR; Murphy S; Byrne E; Moore SN; Shepherd JP et al. The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial. BMC Public Health 10: e-607, 2010. (29 refs.)

Background: Licensed premises offer a valuable point of intervention to reduce alcohol-related harm. Objective: To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations. Design: A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED) records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises. Results: The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level. Conclusion: The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police officers. Police data were of sufficient quality to identify disorder and street surveys are a feasible method for measuring intoxication at the individual level.

Ridner SL; Myers JA; Hahn EJ; Ciszewski TN. College students' exposure to tobacco marketing in nightclubs and bars. Journal of American College Health 59(3): 159-164, 2011. (33 refs.)

Objective: To examine whether a college student's exposure to tobacco marketing in nightclubs and bars was affected by the presence of a smoke-free law. Participants: A random sample (N = 478) of students participated in the survey (no smoke-free law, n = 240; smoke-free law, n = 238). The analysis was limited to students who reported being in nightclubs and bars (n = 171). Methods: A nonexperimental, cross-sectional, 2-group design was used. Results: Students in the smoke-free law city were more likely to be approached by tobacco marketers (34.7% versus 20.2%, p = .02), offered free gifts (41.7% versus 24.2%, p = .02), and take free gifts for themselves (34.7% versus 19.2%, p = .02). They were more likely to be exposed to direct marketing strategies (1.83 versus 1.12, p = .02). There was no difference on indirect tobacco marketing by site. Conclusions: Tobacco marketing is pervasive in nightclubs and bars. Smoke-free laws may protect against exposure to secondhand smoke but not the "pro" smoking messages students encounter.

Rosen LJ; Zucker DM; Rosen BJ; Connolly GN. Second-hand smoke levels in Israeli bars, pubs and cafes before and after implementation of smoke-free legislation. European Journal of Public Health 21(1): 15-20, 2011. (29 refs.)

Background: In 2007, Israel passed a law to extend existing restrictions on smoking in public places and to strengthen enforcement. Responsibility for ensuring smoke-free indoor public places was placed on establishment owners. Bars and pubs were included in the law for the first time. This study aimed to assess changes in air quality in popular Israeli bars, pubs and cafes after the implementation of law, and to examine changes in patron numbers, percentage of smoking patrons and venue-seating sections. Methods: Air quality was determined by measuring respirable suspended particles (PM2.5 mu g(-3)) in 33 randomly selected venues in Jerusalem and Tel Aviv, including bars, pubs and cafes, before and after law implementation. Numbers of patrons and smoking patrons were recorded. Results: Average respirable small particles (RSP) level was 245 mu g(-3) prior to implementation and 161 mu g(-3) following implementation of the law, representing a decline of 34% (P = 0.0043). RSP levels decreased in bars and pubs and in cafes. Percentage of smoking patrons declined from 19% to 9% (P = 0.0036). The magnitude of the effect decreased over time (P = 0.0039). Non-smoking establishments were more common following the legislation (P = 0.0047). Conclusion: Indoor air pollution from second-hand smoke in Israeli bars, pubs and cafes in Jerusalem and Tel Aviv declined following the implementation of law. This demonstrates that a law to extend existing restrictions and enforcement policies may help protect workers and patrons from tobacco smoke. However, RSP levels in Israeli bars and pubs, especially in Tel Aviv, remain unacceptably high. Enforced, 100% smoke-free laws are essential for complete protection.

Saltz RF; Paschall MJ; McGaffigan RP; Nygaard PMO. Alcohol risk management in college settings the Safer California Universities randomized trial. American Journal of Preventive Medicine 39(6): 491-499, 2010. (20 refs.)

Context: Potentially effective environmental strategies have been recommended to reduce heavy alcohol use among college students. However, studies to date on environmental prevention strategies are few in number and have been limited by their nonexperimental designs, inadequate sample sizes, and lack of attention to settings where the majority of heavy drinking events occur. Purpose: To determine whether environmental prevention strategies targeting off-campus settings would reduce the likelihood and incidence of student intoxication at those settings. Design: The Safer California Universities study involved 14 large public universities, half of which were assigned randomly to the Safer intervention condition after baseline data collection in 2003. Environmental interventions took place in 2005 and 2006 after 1 year of planning with seven Safer intervention universities. Random cross-sectional samples of undergraduates completed online surveys in four consecutive fall semesters (2003-2006). Setting/participants: Campuses and communities surrounding eight campuses of the University of California and six in the California State University system were utilized. The study used random samples of undergraduates (similar to 500-1000 per campus per year) attending the 14 public California universities. Intervention: Safer environmental interventions included nuisance party enforcement operations, minor decoy operations, driving-under-the-influence checkpoints, social host ordinances, and use of campus and local media to increase the visibility of environmental strategies. Main outcome measures: Proportion of drinking occasions in which students drank to intoxication at six different settings during the fall semester (residence hall party, campus event, fraternity or sorority party, party at off-campus apartment or house, bar/restaurant, outdoor setting), any intoxication at each setting during the semester, and whether students drank to intoxication the last time they went to each setting. Results: Significant reductions in the incidence and likelihood of intoxication at off-campus parties and bars/restaurants were observed for Safer intervention universities compared to controls. A lower likelihood of intoxication was observed also for Safer intervention universities the last time students drank at an off-campus party (OR=0.81, 95% CI=0.68, 0.97); a bar or restaurant (OR=0.76, 95% CI=0.62, 0.94); or any setting (OR=0.80, 95% CI=0.65, 0.97). No increase in intoxication (e. g., displacement) appeared in other settings. Further, stronger intervention effects were achieved at Safer universities with the highest level of implementation. Conclusions: Environmental prevention strategies targeting settings where the majority of heavy drinking events occur appear to be effective in reducing the incidence and likelihood of intoxication among college students.

Schoj V; Alderete M; Ruiz E; Hasdeu S; Linetzky B; Ferrante D. The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquen, Argentina. Tobacco Control 19(2): 134-137, 2010. (31 refs.)

Objectives The objective of this study was to evaluate the impact of 100% smoke-free environment legislation on respiratory and sensory irritation symptoms and respiratory function among bar and restaurant workers from the city of Neuquen, Argentina. Methods: Pre-ban and post-ban studies without a comparison group in an Argentinean city were conducted. A baseline survey and spirometric measurements were performed with a total of 80 bar and restaurant workers 1 month before (October 2007) and 3 months after (March 2008) the implementation of the new 100% smoke-free legislation. Results: A significant reduction in secondhand smoke exposure was observed after the enactment and enforcement of the new legislation, and an important reduction in respiratory symptoms (from a pre-ban level of 57.5% to a post-ban level of only 28.8%). The reduction of sensory irritation symptoms was even higher. From 86.3% of workers who reported at least one sensory irritation symptom in October 2007, only 37.5% reported the same symptoms in March 2008. Also, data obtained by spirometry showed a significant forced vital capacity increase. Conclusions: Consistent with other studies, 100% smoke-free legislation improved short-term health outcomes in the sample and should be implemented nationwide. Furthermore, undertaking this study has been highly important in promoting 100% smoke-free environment legislation at the workplace as a legitimate right of hospitality workers, and in reducing social acceptance of designated smoking areas in bars and restaurants.

Semple S; van Tongeren M; Galea KS; Maccalman L; Gee I; Parry O et al. UK Smoke-Free Legislation: Changes in PM2.5 concentrations in bars in Scotland, England, and Wales. Annals of Occupational Hygiene 54(3): 272-280, 2010. (21 refs.)

Design: Air quality was measured in 106 randomly selected bars in Scotland, England, and Wales before and after the introduction of smoking restrictions. Methods: PM2.5 concentrations were measured covertly for 30-min periods before smoke-free legislation was introduced, again at 1-2 months post-ban (except Wales) and then at 12-months post-baseline (except Scotland). In Scotland and England, overt measurements were carried out to assess bar workers' full-shift personal exposures to PM2.5. Postcode data were used to determine socio-economic status of the bar location. Results: PM2.5 levels prior to smoke-free legislation were highest in Scotland (median 197 mu g m(-3)), followed by Wales (median 184 mu g m(-3)) and England (median 92 mu g m(-3)). All three countries experienced a substantial reduction in PM2.5 concentrations following the introduction of the legislation with the median reduction ranging from 84 to 93%. Personal exposure reductions were also within this range. There was evidence that bars located in more deprived postcodes had higher PM2.5 levels prior to the legislation. Conclusions: Prior to legislation PM2.5 concentrations within bars across the UK were much higher than the 65 mu g m(-3) 'unhealthy' threshold for outdoor air quality as set by the US Environmental Protection Agency. Concentrations in Scottish and Welsh bars were, on average, two or more times greater than in English bars for which seasonal influences may be responsible. Legislation in all three countries produced improvements in indoor air quality that are consistent with other international studies.

Stockwell T. Commentary on Kypri, et al. (2011): Fighting the good fight against alcohol-related violence: one bar or one hour at a time? (commentary). Addiction 106(2): 311-312, 2011. (13 refs.)

Sumnall H; Bellis MA; Hughes K; Calafat A; Juan M; Mendes F. A choice between fun or health? Relationships between nightlife substance use, happiness, and mental well-being. Journal of Substance Use 15(2): 89-104, 2010. (75 refs.)

Objective: To examine the substance use behaviours of young adults in Europe and to explore the association with self reported indices of mental well being, and the relative value of health. Method: 1341 16-35-year-olds, representing youth and young adults who routinely engage in nightlife, were surveyed in nine European cities. Participants self-completed questionnaires, designed to gather demographic, social, and behavioural data on historic and current substance use, risk behaviours, and mental well being. Results: Controlling for inter-country differences, we found that early initiation and frequency of use of a range of substances was associated with poorer life satisfaction, suicidal ideation, and hopelessness. Younger, more frequent substance users placed greater value on having fun than maintaining long-term health. Bi/homosexual participants were more likely to report hopelessness, suicidal thoughts, dissatisfaction with life, and preferring fun to health. Younger cocaine initiates were more likely to report considering suicide in the last 12 months than older initiates. Conclusions: These findings confirm the importance of early intervention for young substance users. Whilst our study does not make assumptions on causality, identification of substance use in nightclub attendees may be a good marker of comorbid disorders. It is important to recognize that negative mental states may also partly be a product of lifestyle and socioeconomic factors. Prevention and harm reduction interventions should recognize that the most at risk young people may discount future health gains from reducing their substance use.

Thombs DL; O'Mara RJ; Hou W; Wagenaar AC; Dong HJ; Merves ML et al. 5-HTTLPR genotype and associations with intoxication and intention to drive: Results from a field study of bar patrons. Addiction Biology 16(1): 133-141, 2011. (27 refs.)

The serotonin transporter promoter polymorphism (5-HTTLPR) has been linked to a number of human behavioral traits and disorders. The variants of 5-HTTLPR are commonly reported in three forms, L/L, S/L and S/S, with the latter most often associated with emotional distress and/or behavioral dysfunction. Missing from the research literature are investigations that assess event-level associations between 5-HTTLPR genotype and specific incidents of risk behavior in natural drinking settings. This study reports associations between 5-HTTLPR, alcohol intoxication and intention to drive among young adult patrons exiting on-premise drinking establishments (i.e. bars) at night. Self-report measures, breath alcohol concentration (BrAC) readings and saliva samples for DNA analysis were collected from 477 bar patrons. Analyses were performed on 225 patrons likely to be near their peak intoxication level for the night. Results from a linear regression revealed that the 5-HTTLPR genotype was associated with exiting patron BrAC, after adjusting for random and fixed effects of other variables. An interaction effect involving 5-HTTLPR and bar-sponsored drink specials also had an independent association with BrAC, suggesting that selection of price-discounted alcoholic beverages increased intoxication in patrons with an L allele. In addition, results from logistic regression indicated that patrons with the S/S genotype were three times more likely to intend to drive a motor vehicle (after drinking on the night of study participation) compared with those with the L/L genotype. The 5-HTTLPR genotype may play an important role in the etiology of problems associated with on-premise drinking establishments.

Thombs DL; O'Mara RJ; Tsukamoto M; Rossheim ME; Weiler RM; Merves ML et al. Event-level analyses of energy drink consumption and alcohol intoxication in bar patrons. Addictive Behaviors 35(4): 325-330, 2010. (22 refs.)

Aim: To assess event-level associations between energy drink consumption, alcohol intoxication, and intention to drive a motor vehicle in patrons exiting bars at night. Method: Alcohol field study. Data collected in a U.S. college bar district from 802 randomly selected and self-selected patrons. Anonymous interview and Survey data were obtained as well as breath alcohol concentration (BrAC) readings. Results: Results from logistic regression models revealed that patrons who had consumed alcohol mixed with energy drinks were at a 3-fold increased risk of leaving a bar highly intoxicated (BrAC >= 0.08 g/210 L), as well as a 4-fold increased risk of intending to drive upon leaving the bar district, compared to other drinking patrons who did not consume alcoholic beverages mixed with energy drinks. Discussion: These event-level associations provide additional evidence that energy drink consumption by young adults at bars is a marker for elevated involvement in nighttime risk-taking behavior. Further field research is needed to develop sound regulatory policy on alcohol/energy drink sales practices of on-premise establishments.

Thombs DL; O'Mara R; Tobler AL; Wagenaar AC; Clapp JD. Relationships between drinking onset, alcohol use intensity, and nighttime risk behaviors in a college bar district. American Journal of Drug and Alcohol Abuse 35(6): 421-428, 2009. (36 refs.)

Objective: To identify antecedents of risk behavior events in college bar patrons. Methods: In this nighttime field study, self-report data and alcohol intoxication readings were collected from patrons immediately upon exiting bars (n = 618). Results: Multilevel structural equation modeling revealed positive associations between age of drinking onset and both alcohol use intensity in the past year and recent bar-going frequency. In turn, alcohol use intensity in the past year was positively associated with bar-going frequency and intoxication at bar exit. An association between drinking onset and bar-going frequency was mediated by alcohol use intensity in the past year. Conclusions: Discernable paths from age of drinking onset to monthly bar-going frequency and intoxication level after leaving a bar can be identified. The results highlight the critical role of drinking onset in development of college student alcohol abuse. Research is needed to determine whether college bars are environmental pathogens mediating between genetic risk factors and patron risk behavior.

Wells BE; Kelly BC; Golub SA; Grov C; Parsons JT. Patterns of alcohol consumption and sexual behavior among young adults in nightclubs. American Journal of Drug and Alcohol Abuse 36(1): 39-45, 2010. (29 refs.)

Background: Alcohol consumption has been linked to a variety of sexual risk behaviors. However, much research addresses this connection among college students, ignoring other social contexts in which this association may be prevalent, such as club settings. Objectives: As such, this study assessed patterns of drinking and sexual activity among young adults who frequent nightclubs. Methods: Using time-space sampling, we surveyed 308 young adults (ages 18-29) in New York City clubs. Results: Participants reported binge drinking on 52% of drinking days. Roughly, 62% reported recent sex under the influence, and 29% of them reported being less safe in sexual situations as a result of their drinking. Men reported more days of drinking and binge drinking than women, and were more likely to report recent sex under the influence. Younger participants were more likely to report being less safe sexually while intoxicated. Recent binge drinking was associated with sex after drinking. Conclusions and Scientific Significance: These data suggest the need for targeted intervention and prevention efforts at nightclubs.

York NL; Lee K. A baseline evaluation of casino air quality after enactment of Nevada's Clean Indoor Air Act. Public Health Nursing 27(2): 158-163, 2010. (33 refs.)

Objective The U.S. Surgeon General reports that there is no safe level of exposure to secondhand smoke (SHS). The purpose of this study was to measure levels of fine particulate matter in nonsmoking casino restaurants after enactment of Nevada's Clean Indoor Air Act (NCIAA). Methods: Fine particulate matter < 2.5 mu m in diameter (PM2.5) concentrations were measured in 16 casino hotel restaurants and gaming areas for a total of 32 venues. A battery-operated SidePak aerosol monitor was discreetly used for at least 30 min in each venue. Results: Nonsmoking restaurant PM2.5 levels ranged from 5 to 101 mu g/m3 (M=31; SD=22.9) while gaming areas ranged from 20 to 73 mu g/m3 (M=48; SD=15.9). There was a significant difference in PM2.5 between restaurants and gaming areas, t(30)=-2.54, p=.017. There was also a strong correlation between the levels of restaurant PM2.5 and gaming area PM2.5 (r=.71; p=.005). Conclusion Fine PM2.5 in all casino areas was above what the Environmental Protection Agency recommends as healthy. This information can be used to educate policy decision makers when discussing potential strengthening of the law.