Serving Substance Abuse Professionals Since 1993

Last Update: 29.03.08

C O R K O N L I N E

powerpoint presentations
CORK database search
resource materials
bibliographies
clinical tools
user services
newsletters
about cork
home

CORK Bibliography: Bars and Alcohol Sale Outlets

86 citations. January 2006 to present

Prepared: March 2008

Abanades S; Farre M; Barral D; Torrens M; Closas N; Langohr K et al. Relative abuse liability of gamma-hydroxybutyric acid, flunitrazepam, and ethanol in club drug users. Journal of Clinical Psychopharmacology 27(6): 625-638, 2007. (62 refs.)

Objectives: Despite the increasing concern about gamma-hydroxybutyric acid (GHB) toxicity, there are few studies examining the clinical pharmacology of GHB and its abuse potential. To evaluate GHB-induced subjective and physiological effects, its relative abuse liability and its impact on psychomotor performance in club drug users. Materials and Methods: Twelve healthy male recreational users of GHB participated in 5 experimental sessions in the framework of a clinical trial. The study was randomized, double-blind, double-dummy, and crossover. Drug conditions were a single oral dose of GHB (40 or 60 mg/kg), ethanol (0.7 g/kg), flunitrazepam (1.25 mg), and placebo. Study variables included vital signs (blood pressure, heart rate, oral temperature, pupil diameter), psychomotor performance (digit symbol substitution test, balance, Maddox-Wing), subjective effects (a set of 13 visual analogue scales, Addiction Research Center Inventory-49 items, and Evaluation of the Subjective Effects of Substanceances with Potential of Abuse questionnaires), and pharmacokinetics. Results: All active conditions induced positive effects related to their abuse potential. The administration of GHB produced euphoria and pleasurable effects with slightly higher ratings than those observed for flunitrazepam and ethanol. gamma-Hydroxybutyric acid induced a biphasic time profile with an initial stimulantlike effect related to the simultaneous rise of plasma concentrations and a latter sedative effect not related to GHB kinetics. gamma-Hydroxybutyric acid increased blood pressure and pupil diameter. Ethanol induced its prototypical effects, and flunitrazepam produced marked sedation. gamma-Hydroxybutyric acid and flunitrazepam impaired psychomotor performance, digit symbol substitution test, and balance task, whereas ethanol, at the dose tested, induced only mild effects exclusively affecting the balance task. Conclusions: Our results suggest a high abuse liability of GHB and flunitrazepam in club drug users.

Akbar-Khanzadeh F; Milz S; Ames A; Spino S; Tex C. Effectiveness of clean indoor air ordinances in controlling environmental tobacco smoke in restaurants. Archives of Environmental Health 59(12): 677-685, 2004. (20 refs.)

Clean indoor air (CIA) ordinances in Toledo, Ohio, and Bowling Green, Ohio, regulate smoking in restaurants to protect patrons and employees. Yet complete protection is questionable because the ordinances allow for smoking in certain dining sections. Two restaurants were studied in each city, one smoking and one nonsmoking. Levels of contaminants related to environmental tobacco smoke (ETS) -- determined by personal and area air monitoring -- in the nonsmoking restaurants were comparable to levels in a control environment. However, levels of ETS-related contaminants in the smoking restaurants, including designated nonsmoking sections, were significantly higher than levels in the control environment. ETS-related contamination of the nonsmoking sections in the smoking restaurants is attributable to direct openings between the smoking and nonsmoking sections. Reasonable protection of employees and patrons against ETS-related contaminants requires strict enforcement of CIA ordinances. Full protection is achievable only with 100% smokefree policies.

Albers AB; Siegel M; Cheng DM; Biener L; Rigotti NA. Effect of smoking regulations in local restaurants on smokers' anti-smoking attitudes and quitting behaviours. Tobacco Control 16(2): 101-106, 2007. (25 refs.)

Objective: To examine the effect of smoking regulations in local restaurants on anti-smoking attitudes and quitting behaviours among adult smokers. Design: Hierarchical linear modelling (HLM) was used to assess the relationship between baseline strength of town-level restaurant smoking regulation and follow-up (1) perceptions of the social acceptability of smoking and (2) quitting behaviours. Setting: Each of the 351 Massachusetts towns was classified as having strong (complete smoking ban) or weak (all other and no smoking restrictions) restaurant smoking regulations. Subjects: 1712 adult smokers of Massachusetts aged >= 18 years at baseline who were interviewed via random-digit-dial telephone survey in 2001-2 and followed up 2 years later. Main outcome measures: Perceived social acceptability of smoking in restaurants and bars, and making a quit attempt and quitting smoking. Results: Among adult smokers who had made a quit attempt at baseline, living in a town with a strong regulation was associated with a threefold increase in the odds of making a quit attempt at follow-up (OR = 3.12; 95% CI 1.51 to 6.44). Regulation was found to have no effect on cessation at follow-up. A notable, although marginal, effect of regulation was observed for perceiving smoking in bars as socially unacceptable only among smokers who reported at baseline that smoking in bars was socially unacceptable. Conclusions: Although local restaurant smoking regulations did not increase smoking cessation rates, they did increase the likelihood of making a quit attempt among smokers who had previously tried to quit, and seem to reinforce anti-social smoking norms among smokers who already viewed smoking in bars as socially unacceptable.

Ao TTH; Sam NE; Masenga EJ; Seage GR; Kapiga SH. Human immunodeficiency virus type 1 among bar and hotel workers in northern Tanzania: The role of alcohol, sexual behavior, and herpes simplex virus type 2. Sexually Transmitted Diseases 33(3): 163-169, 2006. (27 refs.)

Goals: We assessed baseline prevalence of human immunodeficiency virus type I (HIV-1) and other STDs, as well as behavioral and biologic risk factors for HIV-1 in a population of female bar/hotel workers in Moshi, Tanzania. Study Design: Between 2002 and 2003, we enrolled 1042 female bar/hotel workers in an ongoing prospective cohort study. We analyzed data collected at baseline to assess the associations between alcohol, sexual behavior, STDs, and HIV-1 infection. Results: The prevalence of HIV-1 infection was 19.0% (95% confidence interval [CI] = 16.6%-21.4%). Consistent condom use was low (11.1%). HIV-1 was associated with genital ulcers on examination (adjusted odds ratio [AOR] = 2.08, 95% CI = 1.16-3.74), herpes simplex virus type 2 (HSV-2) (AOR = 3.80, 95 % Cl = 2.42-5.97), and problem drinking (AOR = 1.92, 95% CI = 1.06-3.47). Other independent predictors of HIV-1 were increasing age, number of sex partners, cohabitating, formerly married, location of employment, and having a husband with another wife. Conclusions: These findings suggest that programs designed to control HSV-2, reduce the number of sexual partners and alcohol use, and promote condom use could be effective in reducing transmission of HIV-1 in this population.

Barnoya J; Mendoza-Montano C; Navas-Acien A. Secondhand smoke exposure in public places in guatemala: comparison with other Latin American countries. Cancer Epidemiology, Biomarkers & Prevention 16(12): 2730-2735, 2007. (23 refs.)

Objective: To measure secondhand smoke levels in workplaces in Guatemala and to compare exposure to levels in other Latin American cities. Methods: Exposure was estimated by passive sampling of vapor phase nicotine using a filter badge. Filters were placed in 1 hospital, 1 school, 2 universities, 1 government building, the airport, and 10 restaurants/ bars. In total, 103 filters were deployed (plus 7 duplicates and 10 blanks). Nicotine (mu g/m(3)) was measured by gas chromatography. Medians [interquartile ranges (IQR)] of nicotine concentrations were reported and compared with other Latin American cities. A survey about attitudes for smoke-free workplaces was distributed among employees. Results: Nicotine was detected in most (68%) locations surveyed (including workplaces where smoking is banned). The highest levels were found in bars [median, 4.58 mu g/m(3) (IQR, 1.71-6.44)] and restaurants [median, 0.56 [mu g/m(3) (IQR, 0.46-0.71)]. Nicotine concentrations in bars and restaurants were 710 and 114 times higher, respectively, compared with hospital concentrations after adjustment for smoking ban signs, type of ventilation, and volume of the area. Support for smoke-free environments was high, except in bar/restaurant and airport workers. Airborne nicotine levels in Guatemala were similar to those found in other Latin American cities. Conclusion: In Guatemala, exposure to secondhand smoke is highly prevalent. Workers in bars and restaurants are disproportionately exposed to secondhand smoke compared with other workers. There is an urgent need for complete smoke-free legislation and for educating workers about the benefits of smoke-free workplaces.

Bellis MA; Hughes K. Nightlife in Liverpool: Tackling substance use in a flourishing night time economy. Nordic Studies on Alcohol and Drugs 22(English Supplement): 135-138, 2005. (22 refs.)

The city of Liverpool in the North West of England has a long association with music and nightlife. Thirty years of recession has left the city among the most deprived areas. Efforts are underway to revitalize the city with nightlife playing a major role. As is occurring in other European cities, much of the focus is upon harnessing the considerable economic benefits that accompany expanding nightlife while trying to avoid increases, or even reduce, alcohol and drug related problems. (A recent licensing change allows bars to stay open throughout the night.) This overview of the nightlife in Liverpool discusses the patterns of substance use adopted by its patrons and the public health and criminal justice interventions that are being implemented to provide safer night time environments. In the city as elsewhere in England, there is a continuing increase in alcohol , with 35% or men and 28% of women between the ages of 16 and 24 binge drinking at least once a week. Nationally half of all violent crimes are alcohol related. Data on drug consumption is limited, but a cross-European study found that drugs is a steady accompaniment of nighttime clubs, with ecstasy and cocaine the most commonly used. The planned public response is described, including training bar staff to recognize drug emergencies,

Blecher EH. The effects of the Tobacco Products Control Amendment Act of 1999 on restaurant revenues in South Africa: A panel data approach. South African Journal of Economics 74(1): 123-130, 2006. (11 refs.)

Prior to the implementation of this legislation the restaurant industry lobbied that a full-scale ban would severely hurt business. Their lobbying resulted in a restrictive restaurant smoking policy rather than a full-scale ban. Nevertheless the industry argued that this would still severely hurt business citing international evidence in support. The objective of this paper is to investigate the change in restaurant revenues after the implementation of a public smoking ban in South Africa. We use a fixed effects panel model to explore the response of restaurant revenues to the imposition of the ban. Provincial data is used over the period 1995 to 2003 and VAT receipts are used as a proxy of restaurant turnover. We conclude that restrictive restaurant smoking policies have not had a negative effect on restaurant revenue, indicating that claims of countrywide restaurant business declines under such a policy are unwarranted.

Britt H; Toomey TL; Dunsmuir W; Wagenaar A. Propensity for and correlates of alcohol sales to underage youth. Journal of Alcohol and Drug Education 50(2): 25-42, 2006

The current study assessed the propensity for alcohol sales to youth in the late 1990s, following increased efforts to reduce youth access to alcohol. Male and female pseudo-underage buyers (i.e., age ł 21 but judged to appear < 21) attempted to purchase alcohol without age identification at 741 alcohol establishments. One to five purchase attempts were made at each establishment, with 1,065 and 658 attempts at on-premise and off-premise establishments, respectively. The overall sales rate was 26%. Among establishments where more than one purchase attempt was made, 74% sold alcohol to pseudo-underage buyers at least once. The results of this study are encouraging, however, further work is needed to decrease the propensity of illegal alcohol sales to youth.

Centers for Disease Control and Prevention. State smoking restrictions for private-sector worksites, restaurants, and bars -- United States, 1998 and 2004. MMWR. Morbidity and Mortality Weekly Report 54(26): 649-653, 2005. (10 refs.)

Secondhand smoke is a known carcinogen. Exposure to secondhand smoke causes approximately 35,000 heart disease deaths and 3,000 lung cancer deaths among nonsmokers in the United States every year. Two potential policies are possible: establishing smoke-free environments, limit smoking to certain areas within a venue. The CDC reviewed the status of state laws restricting smoking as of December 31, 2004, updating a 1999 study that reported on such laws as of December 31, 1998. This report summarizes the changes in state smoking restrictions for private-sector worksites, restaurants, and bars that occurred during 1999--2004. The findings indicate an increase in the number and restrictiveness of state laws regulating smoking in private-sector worksites, restaurants, and bars from 1999 through 2004. At the end of 2004, however, 16 states still had no restrictions. As of Decemember 31, 2004, six states restricted private sector worksites, five more than in 1999. As of 2004, 8 states restricted smoking in restaurants, only 19 states had no restrictions. In 2004, a total of four states prohibited smoking in bars; there were none in 1999.

Public Domain

Chinet L; Stephan P; Zobel F; Halfon O. Party drug use in techno nights: A field survey among French-speaking Swiss attendees. Pharmacology, Biochemistry and Behavior 86(2): 284-289, 2007. (27 refs.)

This study was designed to investigate the lifestyle and substance use habits of dance music event attendees together with their attitudes toward prevention of substance misuse, harm reduction measures and health-care resources. A total of 302 attendees aged 16-46 years (mean=22.70, S.D.=4.65) were randomly recruited as they entered dance music events. Rates for lifetime and current use (last 30 days) were particularly high for alcohol (95.3% and 86.6%, respectively), cannabis (68.8% and 53.8%, respectively), ecstasy (40.4% and 22.7%, respectively) and cocaine (35.9% and 20.7%, respectively). Several patterns of substance use could be identified: 52% were alcohol and/or cannabis only users, 42% were occasional poly-drug users and 6% were daily poly-drug users. No significant difference was observed between substance use patterns according to gender. Pure techno and open-air events attracted heavier drug users. Psychological problems (such as depressed mood, sleeping problems and anxiety attacks), social problems, dental disorders, accidents and emergency treatment episodes were strongly related to party drug use. Party drug users appeared to be particularly receptive to harm reduction measures, such as on-site emergency staff, pill testing and the availability of cool water, and to prevention of drug use provided via counseling. The greater the involvement in party drug use, the greater the need for prevention personnel to be available for counseling. General practitioners appeared to be key professionals for accessing health-care resources.

Degenhardt L; Dillon P; Duff C; Ross J. Driving, drug use behaviour and risk perceptions of nightclub attendees in Victoria, Australia. International Journal of Drug Policy 17(1): 41-46, 2006. (17 refs.)

Aim: In anticipation of the introduction of roadside saliva testing in Victoria for recent THC and methylamphetamine use, this study examined the prevalence of illicit drug use among nightclub attendees in Melbourne, Victoria; their transport methods; and their drug use and driving histories. Methods: In total, 273 persons were interviewed as they entered nightclubs in the inner Melbourne area. Questionnaires addressed drug use, risk perception and driving behaviour. Results: Drug use on the night of interview was common, with notable proportions reporting that they had used or intended to use cannabis (22%), ecstasy (18%), speed (13%) and crystal/base methamphetamine (6%). Around one in ten participants reported that on the night of interview, they would either drive or be driven by someone under the influence of alcohol (10%), cannabis (11%) and/or methamphetamine (8%). Seventy percent reporting having heard of roadside drug testing and 65% supported it. Forty percent reported that roadside drug testing would change their drug driving behaviour. Conclusions: Roadside drug testing in Victoria may have positive impacts upon drug use and driving risk behaviours among a sample of young persons attending nightclubs. Information provision and increasing the transport options for young people will play a part in reducing the number of young clubbers who use drugs and drive.

Duailibi S; Ponicki W; Grube J; Pinsky I; Laranjeira R; Raw M. The effect of restricting opening hours on alcohol-related violence. American Journal of Public Health 97(12): 2276-2280, 2007. (26 refs.)

Objective. We investigated whether limiting the hours of alcoholic beverage sales in bars had an effect on homicides and violence against women in the Brazilian city of Diadema. The policy to restrict alcohol sales was introduced in July 2002 and prohibited on-premises alcohol sales after 11 PM. Methods. We analyzed data on homicides (1995 to 2005) and violence against women (2000 to 2005) from the Diadema (population 360000) police archives using log-linear regression analyses. Results. The new restriction on drinking hours led to a decrease of almost 9 murders a month. Assaults against women also decreased, but this effect was not significant in models in which we controlled for underlying trends. Conclusions. Introducing restrictions on opening hours resulted in a significant decrease in murders, which confirmed what we know from the literature: restricting access to alcohol can reduce alcohol-related problems. Our results give no support to the converse view, that increasing availability will somehow reduce problems.

Feigelman W; Lee JA. Are Americans receptive to smokefree bars? Journal of Psychoactive Drugs 38(2): 133-141, 2006. (24 refs.)

It is not known whether the American public accepts smokefree bars and restaurants. Anticipating public displeasure with these ordinances, tobacco, liquor and restaurant industry trade associations have helped to stall efforts to pass laws curbing bar and restaurant smoking in the expectation that diminished patronage would inevitably result. This cross-sectional trend study uses data from the May 1993 and January 1999 Current Population Surveys, Tobacco Use Supplements to compare tobacco-control attitudes among American bar and restaurant workers, all other workers, smokers and nonsmokers (total n = 90,661). It was found that by 1999, smokefree workplaces were widely accepted by two-thirds of adults, with half favoring completely smokefree restaurants. Completely smokefree bars remained less popular, with nearly equal numbers (about 30%) preferring them or favoring unrestricted bar smoking. Even among bar and restaurant industry workers less than 10% favored unrestricted restaurant smoking. Greater acceptances of smokefree bars are now taking hold, especially in places like California, where acceptance rose 15% in six years, and 45% preferred them. Opponents to smokefree bars and restaurants may have underestimated the levels of support and growing acceptance of smokefree living areas now taking hold among the general public.

Forsyth AJM. Banning glassware from nightclubs in Glasgow (Scotland): Observed impacts, compliance and patrons views. Alcohol and Alcoholism 43(1): 111-117, 2008. (22 refs.)

Aim: To examine the impact of a glassware ban policy on disorder-related harm within licensed premises (nightclubs) and how this action was viewed by their patrons. Methods: Field observations were conducted in a sample of eight nightclubs following the introduction of this policy across all such venues within a city centre. These observations involved both quantitative and qualitative data collection observing violence in a naturalistic setting, and were supplemented by taped in-depth interviews with nightclub patrons. Results: Exemptions to the ban had enabled some premises (three out of eight) to continue to serve alcoholic drinks in glass vessels, and injurious violence resulting from these practices was observed. Disorder in all-plastic venues was observed to incur less injury risk. Patrons also reported feeling safer in these nightclubs than in others. Conclusions: This research demonstrated the potential of such policy to reduce the severity of alcohol-related violence in the night-time economy. It is recommended that future bans of this nature be tailored towards the elimination of all types of glassware from such premises.

Furr-Holden D; Voas RB; Kelley-Baker T; Miller B. Drug and alcohol-impaired driving among electronic music dance event attendees. Drug and Alcohol Dependence 85(1): 83-86, 2006. (19 refs.)

Background: Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired driving among a high proportion of young adult drug users. EMDEs are late-night dance parties marked by a substantial number of young adult attendees and elevated drug involvement. No studies to date have examined drug-impaired driving in a natural environment with active drug and alcohol users. Methods: Six EMDEs were sampled in San Diego, California, and Baltimore, Maryland. A random sample of approximately 40 attendees per event were administered surveys about alcohol and other drug (AOD) use and driving status, given breath tests for alcohol, and asked to provide oral fluid samples to test for illicit drug use upon entering and exiting the events. Results: Driving status reduced the level of alcohol use (including abstaining) but the impact on drug-taking was not significant. However, 62% of individuals who reported their intention to drive away from the events were positive for drugs or alcohol upon leaving. This suggests that these events and settings are appropriate ones for developing interventions for reducing risks for young adults.

Gee IL; Watson AFR; Carrington J; Edwards PR; van Tongeren M; McElduff P et al. Second-hand smoke levels in UK pubs and bars: Do the English Public Health White Paper proposals go far enough? Journal of Public Health 28(1): 17-23, 2006. (21 refs.)

Background: The English Public Health White Paper proposes introducing smoke-free workplaces except in pubs and bars that do not prepare and serve food. The bar area will be non-smoking in exempted pubs. Objective To explore the likely impact of these proposals in UK pubs and bars. Methods A total of 59 pubs and bars within Greater Manchester in 2001 were chosen. Thirteen were mechanically ventilated, 12 were naturally ventilated and 34 had extractor fans; 23 provided non-smoking areas. We measured time-weighted average concentrations of respirable suspended particles (RSP), solanesol tobacco-specific particles and vapour-phase nicotine (VPN) over a 4-h sampling period on a Tuesday or Saturday night. Results: Second-hand smoke (SHS) levels in smoking areas were high (mean RSP 114.5 mu g/m(3), VPN 88.2 mu g/m(3), solanesol 101.7 mu g/m(3)). There were only small (5-13 per cent) reductions in bar areas. Mean levels were lower in non-smoking areas: by 33 per cent for RSPs, 52 per cent for solanesol particles and 69 per cent for VPN. Compared with other settings (homes and other workplaces) with unrestricted smoking, mean SHS levels were high throughout all areas of the pubs regardless of ventilation strategy. Conclusion: Partial measures, like those in the English Public Health White Paper, will leave bar staff in exempted pubs unprotected from the occupational hazard of SHS.

Goodman P; Agnew M; McCaffrey M; Paul G; Clancy L. Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs. American Journal of Respiratory and Critical Care Medicine 175(8): 840-845, 2007. (36 refs.)

Background: Environmental tobacco smoke (ETS) causes disease in nonsmokers. Workplace bans on smoking are interventions to reduce exposure to ETS to try to prevent harmful health effects. On March 29, 2004, the Irish government introduced the first national comprehensive legislation banning smoking in all workplaces, including bars and restaurants. This study examines the impact of this legislation on air quality in pubs and on respiratory health effects in bar workers in Dublin. Methods: EXPOSURE STUDY. Concentrations of particulate matter 2.5 mu m or smaller (PM2.5) and particulate matter 10 lam or smaller (PM10) in 42 pubs were measured and compared before and after the ban. Benzene concentrations were also measured in 26 of the pubs. HEALTH EFFECTS STUDY. Eighty-one barmen volunteered to have full pulmonary function studies, exhaled breath carbon monoxide, and salivary cotinine levels performed before the ban and repeated 1 year after the ban. They also completed questionnaires on exposure to ETS and respiratory symptoms on both occasions. Findings: EXPOSURE STUDY. There was an 83% reduction in PM2.5 and an 80.2% reduction in benzene concentration in the bars. HEALTH EFFECTS STUDY. There was a 79% reduction in exhaled breath carbon monoxide and an 81% reduction in salivary cotinine. There were statistically significant improvements in measured pulmonary function tests and significant reductions in self-reported symptoms and exposure levels in nonsmoking barmen volunteers after the ban. Conclusions: A total workplace smoking ban results in a significant reduction in air pollution in pubs and an improvement in respiratory health in barmen.

Graham K. Isn't it time we found out more about what the heck happens around American liquor stores? (editorial). Addiction 101(5): 619-620, 2006. (13 refs.)

Graham K; Bernards S; Osgood DW; Wells S. Bad nights or bad bars? Multi-level analysis of environmental predictors of aggression in late-night large-capacity bars and clubs. Addiction 101(11): 1569-1580, 2006. (44 refs.)

Aim: To clarify environmental predictors of bar-room aggression by differentiating relationships due to nightly variations versus across bar variations, frequency versus severity of aggression and patron versus staff aggression. Design, setting and participants : Male-female pairs of researcher-observers conducted 1334 observations in 118 large capacity (> 300) bars and clubs in Toronto, Canada. Measurements :Observers independently rated aspects of the environment (e.g. crowding) at every visit and wrote detailed narratives of each incident of aggression that occurred. Measures of severity of aggression for the visit were calculated by aggregating ratings for each person in aggressive incidents. Findings: Although bivariate analyses confirmed the significance of most environmental predictors of aggression identified in previous research, multivariate analyses identified the following key visit-level predictors (controlling for bar-level relationships): rowdiness/permissive environment and people hanging around after closing predicted both frequency and severity of aggression; sexual activity, contact and competition and people with two or more drinks at closing predicted frequency but not severity of aggression; lack of staff monitoring predicted more severe patron aggression, while having more and better coordinated staff predicted more severe staff aggression. Intoxication of patrons was significantly associated with more frequent and severe patron aggression at the bar level (but not at the visit level) in the multivariate analyses and negatively associated with severity of staff aggression at the visit level. Conclusions: The results demonstrate clearly the importance of the immediate environment (not just the type of bar or characteristics of usual patrons) and the importance of specific environmental factors, including staff behaviour, in predicting both frequency and severity of aggression.

Gripenberg J; Wallin E; Andreasson S. Effects of a community-based drug use prevention program targeting licensed premises. Substance Use & Misuse 42(12-13): 1883-1898, 2007. (31 refs.)

This study evaluated the effects of a community-based drug use prevention program on the frequency with which door men at licensed premises intervene in cases of obviously drug use-impaired patrons. Doormen were trained in recognizing signs of drug use impairment to he able to stop, drug use-impaired patrons to enter the premises. The study included 28 trendy nightclubs in Stockholm, Sweden, that used doormen to screen patrons. Two male actors were instructed to act as if they were obviously drug use-impaired (cocaine/amphetamines) while attempting to enter nightclubs. Data were collected at pretest when 40 entry attempts were made (2003) and posttest (2004) when 48 attempts were made. At follow-up, the doormen intervened in 27% of the attempts, a significant improvement compared to the intervention rate of 7.5% at baseline. The results indicate that the intervention has had effect on doormen's behavior. However, in the majority of the attempted visits, the doormen still did not intervene. Limitations of the study were the lack of a control group and problems with identifying the training status for the individual doormen. Further research is necessary to explore the effectiveness of community-based drug use prevention programs targeting licensed premises.

Gruenewald PJ. The spatial ecology of alcohol problems: Niche theory and assortative drinking. Addiction 102(6): 870-878, 2007. (69 refs.)

Aims: This paper summarizes several theoretical perspectives that serve to explain observed associations between concentrations of alcohol outlets and alcohol-related problems. A critique of each perspective discusses how each addresses the social etiology of these problems; that is, how, where and why these problems arise in association with alcohol outlets? Methods: This theoretical work is based upon mathematical and computational models of the ecology of alcohol-related problems developed in the 'Ecosystems Modeling Project', an advanced research project of the National Institute on Alcohol Abuse and Alcoholism, United States. Results Associations between outlets and problems are thought to arise from the concentration of individuals in drinking places ('flow models'), the attraction of some places for people at risk for problems ('gravity models'), or because outlets are located in high-risk neighborhoods and have negative social normative effects ('social contextual models'). None of these approaches explain how some outlets come to have more problems than others (e.g. violent outlets). An alternative social ecological model is introduced which asserts that the complementary processes of niche marketing and assortative drinking form the social dynamic that explains these relationships. Alcohol sellers 'niche market' to select social strata, drinkers return to establishments at which they find people like themselves, and consequent social stratification of the market-place increases the levels of related problems in some outlets. Conclusions: The proposed mechanism is very general, and suggests that over-concentrations of outlets will lead to stratification of drinking groups and intensification of problems related to those outlets.

Gruenewald PJ; Freisthler B; Remer L; LaScala EA; Treno A. Ecological models of alcohol outlets and violent assaults: Crime potentials and geospatial analysis. Addiction 101(5): 666-677, 2006. (40 refs.)

Aims: Empirical tests of relationships between alcohol outlets and violence are generally conducted with statistical controls for correlates related to characteristics of people and the places in which they live. Crime potentials theory asserts that certain subpopulations are disposed to participate in criminal activities (population potentials) and certain neighborhoods are more likely to be places where crimes occur (place potentials). The current study assesses the degree to which measures of the different geographic distributions of these potentials contribute to violent crime. Design: Cross-sectional data on hospital discharges for violent assaults were obtained for residents of 1637 zip code areas in California. Assault rates were related to measures of population and place characteristics using spatial statistical models corrected for spatial autocorrelated error. Findings: Rates of assault were related to population and place characteristics within zip code areas, and with characteristics of populations living in adjacent zip code areas. Assault rates were greater in densely populated, poor minority urban areas with greater residential instability. Assault rates were also greater in zip code areas adjacent to densely populated urban areas. Assault rates were related significantly to local densities of off-premise alcohol retail establishments, not bars. However, densities of bars moderated substantially effects related to local population characteristics. Bars were related significantly to violence in unstable poor minority areas and in rural middle-income areas of the state. Conclusion: Population and place characteristics are associated with rates of violence across spatial areas. Alcohol outlets directly affect and moderate potentials for violence associated with socio-demographic groups.

Gruenewald PJ; Remer L. Changes in outlet densities affect violence rates. Alcoholism: Clinical and Experimental Research 30(7): 1184-1193, 2006. (24 refs.)

Background: Previous assessments of empirical relationships between alcohol outlets and rates of interpersonal violence have been conducted using cross-sectional spatial data, data collected across small geographic units such as Census Tracts and zip codes. These assessments demonstrate that the availability of alcohol, measured by the number and types of alcohol outlets, is related to violence. These analyses have examined many potential confounds of the outlets-violence connection (i.e., population and place characteristics) and statistically corrected for biases that arise in analyses of spatial data. The current study contributes the first observation of longitudinal relationships between alcohol outlets and violence. Method: The study examined longitudinal data from 581 consistently defined zip code areas represented in the California Index Locations Database, a geographic information system that coordinates population and ecological data with spatial attributes for areas across the state. Six years of data were collected on features of local populations (e.g., household size) and places (e.g., retail markets) thought to be related to 1 measure of violence (i.e., hospital discharges related to violent assaults). Assault rates were related to changes in population and place characteristics using random effects models with controls for spatial autocorrelation (n x t = 3,486 observations). Changes in population and place characteristics of bordering (spatial lagged) areas were also considered. Results: Lower median household income and greater percentages of minorities (African American, Hispanic, and Asian) were related to increased rates of violence. Ten percent increases in numbers of off-premise outlets and bars were related to 1.67 and 2.06% increases in violence rates across local and lagged spatial areas. Every 6 outlets accounted for 1 additional violent assault that resulted in at least 1 overnight stay at hospital. These effects increased with larger male populations, doubling with every 3% increase in percent males. Conclusion: Assault rates were most strongly related to median household incomes and minority populations within zip code areas. Controlling for changes in assault rates related to these measures, greater numbers of licensed alcohol retail establishments, especially bars and off-premise outlets, were related to rates of assault. Failures to regulate the growth in numbers of bars will increase rates of violence, especially in urban areas.

Gruskin E; Byrne K; Kools S; Altschuler A. Consequences of frequenting the lesbian bar. Women & Health 44(2): 103-120, 2006. (23 refs.)

Research indicates that lesbian's who frequent bars are more likely to drink and that lesbians drink more than their heterosexual counterparts. We explored in detail the consequences of lesbians' bar attendance. We conducted 35 in-person, semi-structured interviews and analyzed the data using qualitative methods. The findings are organized into the following categories: safety and support over the life course: lesbian identity development; reduction of stress; and social networks and intimate relationships. In each category, participants' stories are presented to highlight the health tradeoffs associated with bar patronage, the psychosocial importance of the bar, and the relationship between minority stress and alcohol use. Public health implications are discussed.

2006, Haworth Press

Gutzke D. Pubs and Progressives. Reinventing the Public House in England, 1896-1960. De Kalb IL: Northern Illinois University Press, 2006. (Chapter refs.)

This volume traces the changes which occurred in the pubs of England from the early 1900s through the decade post WWII. In the early years of this period, social reformers along side progressive brewers worked collaboratively to mprove into the drinking environment. These efforts increawsed in the wake of WW I and the experience of a number of groups, such as the True Temperance Association, the Fellowship of Freedom and Reform and the Association for the Promotion of Restaurant Public Houses in Poor Districts. The latter worked to bring cheap refreshment facilities to areas such as Somers Town, one of the poorest areas of London. Cultural events were added too, for example, as The Committee for Verse and Prose Recitation hosted poetry and dramatic readings in the pubs. Brewers saw economic advantages in the creation/refurbishing of drinking establishments that would be respectable for familes. A number of upscale lounges were opened during the 1920s which served cocktails as well as pints. After WW II this effort at improvement was largely abandoned. In fact, it had never penetrated the whole country, but was largely confined to the Home Counties, the North and the Midlands. The majority of pubs were still for "serious drinkers." Over all the number serving meals declined as restaurants became more popular.

Gyimah-Brempong K; Racine J. Alcohol availability and crime: A robust approach. Applied Economics 38(11): 1293-1307, 2006. (40 refs.)

The relationship between alcohol availability and crime is investigated in this study. It first considers common parametric specifications that have been used in the literature. After applying a powerful consistent conditional moment test for correct specification, it is found that these common parametric specifications are rejected by the data. The study then proceeds with a robust nonparametric method that can have a rate of convergence close to that for a correctly specified parametric model when the underlying relationship is somewhat linear. The application of nonparametric methods reveals structure present in the data that would remain undetected when applying common parametric specifications, but more importantly reveals that the impact of alcohol availability is considerably higher than one might believe on the basis of the misspecified parametric model. It is also found that the marginal effect of alcohol availability on crime changes with the level of alcohol availability.

Hahn EJ; Rayens MK; York N; Okoli CTC; Zhang M; Dignan M et al. Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers. Journal of Occupational and Environmental Medicine 48(9): 906-913, 2006. (59 refs.)

Objective: Bar and restaurant workers' exposure to secondhand smoke (SHS) was compared before and 3 and 6 months after implementation of a smoke-free ordinance. Methods: Hair nicotine, self-reported exposure to SHS, and respiratory symptoms were assessed on 105 smoking and nonsmoking workers from randomly selected establishments in Lexington, Kentucky. Thirty-eight percent were current smokers with more than half smoking 10 or fewer cigarettes per day. Workers provided a hair sample at baseline and at the 3-month interview. Results: There was a significant decline in hair nicotine 3 months post law when controlling for cigarettes smoked per day. Bar workers showed a significantly larger decline in hair nicotine compared with restaurant workers. The only significant decline in SHS exposure was in the workplace and other public places. Regardless of smoking status, respiratory symptoms declined significantly postlaw. Conclusions: Hospitality workers demonstrated significant declines in hair nicotine and respiratory symptoms after the law. Comprehensive smoke-free laws can provide the greatest protection to bar workers who are the most vulnerable to SHS exposure at work.

Holder HD. Alcohol and the Community: A Systems Approach to Prevention. Cambridge: Cambridge University Press, 2006

An individual's decision to use alcohol and the frequency, quantity and situation in which drinking takes place are the result of a combination of biological and social factors. Drinking is not only a personal choice, but also a matter of custom and social behaviour, and is influenced by access and economic factors including levels of disposable income and cost of alcoholic beverages. Until prevention efforts cease to focus narrowly on the individual and begin to adopt broader community perspectives on alcohol problems and strategies to reduce them, these efforts will fail. The author challenges the current implicit models used in alcohol problem prevention and demonstrates an ecological perspective of the community as a complex adaptive system composed of interacting subsystems, an appreciation and understanding of which offers a new approach to the prevention of alcohol dependence and alcohol-related problems. The book is organized into 8 chapters. following an introduction, the author begins the discussion a discussion of the patterns of consumption and influences on consumption patterns. Attention then turns to what are considered different subsystems influencing consumption, each a subject of an individual chapter. These include retail sales, and the role of alcohol availability and promotion; formal regulations, including rules, their administration and enforcement; social norms, and community values that influence drinking patterns; legal sanction that are involved in the prohbition of drinking; and the social/economic/health consequences as they are recognized by the community. The concluding chapter addresses the need for and community level approaches to alcohol problems.

Holder HD. What we learn from a reduction in the retail alcohol prices: Lessons from Finland. Addiction 102(3): 346-347, 2007. (2 refs.)

Homel R. Drink driving and the regulates of drinking: When will governments learn? (commentary on Chikritzhs and Stockwell). Addiction 101(9): 1228-1229, 2006. (7 refs.)

Huckle T; Greenaway S; Broughton D; Conway K. The use of an evidence-based community action intervention to improve age verification practices for alcohol purchase. Substance Use & Misuse 42(12-13): 1899-1914, 2007. (15 refs.)

Alcohol purchase surveys were undertaken as part of two New Zealand community action projects (one in a large metropolitan area and one in a small town) that aimed at reducing alcohol consumption-related harm for young people. Baseline surveys in both places indicated poor age verification practices. The two follow-up surveys in the metropolitan area showed a decrease in sales made without age identification between 2002 (60%) and 2003 (46%). However, an increase between 2003 (46%) and 2004 (55%) occurred. In the metropolitan area, regulatory staff in three out of seven jurisdictions increased enforcement due to the 2002 survey and follow-up work; this did not happen following the 2003 survey. In the small town, results indicated positive changes in verification practices over time. In addition, licensee meetings, host responsibility training, and a regional project all occurred following the surveys. The surveys have also had important indirect effects. Closer monitoring and enforcement activity due to the surveys has contributed to the amendment of alcohol legislation in New Zealand.

Jang YC; Kim YF; Lee JW; Oh SJ; Han KW; Lee JW et al. Face burns caused by flambe drinks. Journal of Burn Care & Research 27(1): 93-96, 2006. (16 refs.)

This study was conducted to identify the epidemiology of face burns in Korean adults caused by flambe drinks in the hope of developing preventive programs. We reviewed the medical records of 25 patients with burns caused by flame drinks that were admitted to the Hallym Burn Centre, Hangang Sacred Heart Hospital, Seoul, Korea, during the 30-month period of July 2002 to December 2004. The injuries occurred while drinking and spilling the whisky on the flame (68%) during the hours of social gathering and festivity. There were more men than women (male:female ratio = 21:4); the mean age was 27.5 +/- 5.7 years (mean 27, range 21-43 years). Alcohol flames inflicted superficial (56%) to mid-second degree burns in a relatively small area of body (TBSA 3.2 +/- 3.0%). The head was most commonly involved, followed by the upper extremity and trunk. All patients except two were treated with observation and daily dressing changes only. The mean length of hospital stay was 12.1 +/- 6.5 (10, 5-25) days. Long-term cosmetic outcomes were excellent. Some victims suffered mild corneal (n = 4) and ear (n = 6) burns, without permanent sequelae. Post-traumatic stress disorder and depression also were reported. Burn injuries induced by flambe drinks may be prevented by increasing public awareness about its danger and the potential risk for corneal and facial burns and by implementing a safety policy. All the involved parties -- public, distillers, and bar and restaurant management -- need to coordinate their efforts achieve a reduction in injuries.

Jones SC; Lynch M. Non-advertising alcohol promotions in licensed premises: Does the Code of Practice ensure responsible promotion of alcohol? Drug and Alcohol Review 26(5): 477-485, 2007. (34 refs.)

Introduction and Aims. Binge drinking is a major public health issue in Australia, particularly among young people. There has been a considerable focus on alcohol advertising, among both researchers and policy makers, resulting in efforts to bring about some level of regulation of unacceptable advertising practices. However-despite the existence of a Code of Practice for Responsible Promotion of Liquor Products which provides 'a framework of practices which are considered acceptable and reasonable for licensed premises-there are few, if any, data on the nature and extent of promotions which could arguably fall under either 'acceptable' or 'unacceptable' practices. Design and Methods. Over an 8-week period we monitored promotions offered by licensed venues (pubs, bars and clubs) in the Wollongong central area. Seventeen venues were identified, and each venue was visited daily for I week. Trained research assistants took notes on all promotions/events in visited venues, including both manufacturer- and management-initiated. Results. We identified a range of different types of promotions, including low cost and free drinks. Some of the promotions identified could be seen to have a positive public health impact, such as free food and free transport. However, the majority of promotions were of a nature likely to increase the likelihood of excessive drinking. Discussion and Conclusions. It is evident from this review that there are numerous examples of promotions which breach both the spirit and the letter of the Code. It is equally evident that the system for monitoring compliance with the Code is fundamentally inadequate.

Kahn G; Hirschfeld A. The Speakeasies of 1932. New York: Applause Books, 2005

This book, originally published in 1932 under the title "Manhattan Oases" has long been out of print. It celebrate three dozen illegal drinking establishments -- among the estimated thirty-two thousand that sprang up in New York City during Prohibition. The bars featured ranged from the high brow, with admission requiring a wooden card, to a Bowery dive. Hirschfeld's pen-and-ink drawings offer a window onto the Jazz Age. The trademark illustrations capture the feeling of bartenders, both straight-faced and dour, as well as of the patrons, some dressed for dance, others longing to bend an ear. On the page facing each drawing is a short essay on the drinking establishment, written by Gordon Kahn and Al Hirschfeld. Following the description is a recipe for that place's signature drink; these range from the gin daisy, horse's neck, brandy flip, to the prairie-oyster cocktail. For Mike's bar in Harlem, the authors' write, "Caucasian patronage is tolerated but not solicited," and the Pink Lady Cocktail is made with grenadine, brandy, gin and egg white. Hirschfeld depicts the bartender Ralph, serving a sophisticated, blasŽ black couple, sitting at the same table as a derelict-looking white man.

Kairouz S; Greenfield TK. A comparative multi-level analysis of contextual drinking in American and Canadian adults. Addiction 102(1): 71-80, 2007. (46 refs.)

To investigate the effects of demographic factors and drinking location on contextual drinking in a comparison of US and Canadian adults. Multi-level techniques were used to model the two-level hierarchical structure of drinking contexts (level 1) nested within individuals (level 2). Two random samples of current drinkers aged 18 years or older were drawn from Canada's Alcohol and Other Drugs Survey (CADS, 1994) and the 1995 National Alcohol Survey (NAS 9). The US sample included 2,304 respondents (level 2) who reported a total of 5,956 drinking contexts (level 1); in Canada, 5,394 respondents reported 13,235 drinking contexts. Participants reported usual alcohol intake in up to four drinking locations. Demographic data included age, gender, education level, income and marital status. Significant variation in usual alcohol intake was observed between drinking locations in both the US and Canada. The full multi-level models explained 25% of the variance at the contextual level and 25% and 22% at the individual level in the US and Canada. Contextual drinking was determined by a complex relationship between demographic characteristics and drinking locations. Some interactions between locations and demographic variables were observed for both the US and Canada, whereas others were observed only in the US sample. There is a need, from a population health perspective, for a multi-level approach in epidemiology and prevention that considers drinking setting as a relevant level for analysis and intervention.

2007, Society for the Study of Addiction to Alcohol and Other Drugs

Ker K; Chinnock P. Interventions in the alcohol server setting for preventing injuries. Cochrane Database of Systemic Reviews 2006(2): article CD005244.pub2, 2006. (81 refs.)

Background: Injuries are a significant public health burden and alcohol intoxication is recognised as a risk factor for injuries. There is increasing attention on supply-side interventions, which aim to modify the environment and context within which alcohol is supplied and consumed. Objectives: To quantify the effectiveness of interventions implemented in the server setting for reducing injuries. Search strategy: We searched the Cochrane Injuries Group Specialised Register (September 2004), Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2004), MEDLINE (January 1966 to September 2004), EMBASE (1980 to 2004, wk 36), other specialised databases and reference lists of articles. We also contacted experts in the field. Selection criteria: Randomised controlled trials (RCTs) and non-randomised controlled studies (NRS) of the effectiveness of interventions administered in the server setting which attempted to modify the conditions under which alcohol is served and consumed, to facilitate sensible alcohol consumption and reduce the occurrence of alcohol-related harm. Data collection and analysis: Two authors independently screened search results and assessed the full texts of potentially relevant studies for inclusion. Data were extracted and methodological quality was examined. Due to variability in the intervention types investigated, a pooled analysis was not appropriate. Main results: Twenty studies met the inclusion criteria. Overall methodological quality was poor. Five studies used an injury outcome measure; only one of these studies was randomised. The studies were grouped into broad categories according to intervention type. One NRS investigated server training and estimated a reduction of 23% in single vehicle night-time crashes in the experimental area (controlled for crashes in the control area). Another NRS examined the impact of a drink driving service, and reported a reduction in injury road crashes of 15% in the experimental area, with no change in the control; no difference was found for fatal crashes. One NRS investigating the impact of a policy intervention, reported that pre-intervention the serious assault rate in the experimental area was 52% higher than the rate in the control area. After intervention, the serious assault rate in the experimental area was 37% lower than in the control. The only RCT targeting the server setting environment with an injury outcome compared toughened glassware ( experimental) to annealed glassware ( control) on number of bar staff injuries; a greater number of injuries were detected in the experimental group (relative risk 1.72, 95% CI 1.15 to 2.59). A NRS investigating the impact of a intervention aiming to reduce crime experienced by drinking premises; found a lower rate of all crime in the experimental premises (rate ratio 4.6, 95% CI 1.7 to 12, P = 0.01), no difference was found for injury (rate ratio 1.1. 95% CI 0.1 to 10, P = 0.093). The effectiveness of the interventions on patron alcohol consumption is inconclusive. One randomised trial found a statistically significant reduction in observed severe aggression exhibited by patrons. There is some indication of improved server behaviour but it is difficult to predict what effect this might have on injury risk. Authors' conclusions: There is no reliable evidence that interventions in the alcohol server setting are effective in reducing injury. Compliance with interventions appears to be a problem; hence mandated interventions may be more likely to show an effect. Randomised controlled trials, with adequate allocation concealment and blinding are required to improve the evidence base. Further well conducted non-randomised trials are also needed, when random allocation is not feasible.

Kerber CS; Schlenker E. Use of a breathalyzer in a local bar: A community education project. Journal of Nursing Education 45(11): 455-457, 2006. (6 refs.)

In completing a faculty-assigned service-learning project, a group of nursing students sought to educate their peers and the public about the effects of alcohol consumption. Breathalyzer readings were obtained from 150 bar patrons and correlated with the number of drinks consumed and number of hours spent drinking. The results were used to educate bar patrons about the difference between how intoxicated they felt and their actual blood alcohol levels. The students also distributed information about substance abuse assistance and safe transportation home. This screening technique served as an application of secondary prevention principles for the nursing students. The project was considered innovative in that no similar study was found in the literature. Selected Healthy People 2010 goals were also addressed in this project.

2006, Slack

Kolvin P, ed. Licensed Premises: Law & Practice. Haywards Heath (England): Tottel Publishing, 2004. (Chapter refs.)

In 2005 the licensing laws for alcohol outlets in England and Wales changed, extending the late night hours in order to promote the development of 'the night-time economy' while maintaining public safety. The editor is the Chair of the Licensing Board of Britain. The first section deals with the issues at the local level. National regulatory policies inevitably are put into effect in local communities, and it is within these communities that licensing and enforcement authorities attempt to ensure that these regulations are followed. Local implementation can fail because national policies are written poorly or local licensing and enforcement authorities are supported poorly in their efforts to protect public welfare. To observe the legal and regulatory processes by which one national policy grapples with these issues, there is no better educator than this text. The fist deals with the kinds of licenses and conditions for licensing, followed by a the major policy issues, and discussion of common public problems -- policing, noise abatement and regulation of sex establishments. Note: One reviewer (Paul Gruenwald, "Addiction" 101(4): 172) notes that despite the wealth of information there is one problem: the romanticizing of drinking, not acknowledging the problems which accompany alcohol, and chalking these up to persons who are 'irresponsible' or 'punters' and 'angry young men.'

Kotani K; Osaki Y; Kurozawa Y; Kishimoto T. Insufficient smoking restrictions in restaurants around junior high schools in Japan. Tohoku Journal of Experimental Medicine 210(4): 349-353, 2006. (20 refs.)

Controls for second hand smoke (SHS) and adolescent smoking have been still sociomedical concerns in Japan. Restaurant smoking restrictions are associated with community social norms affecting adolescent smoking behavior, and the status in areas around Junior high schools (JHSs) in the community could be a sign of community practices on regulating SHS for adolescents. To examine whether restaurant smoking restrictions are seen especially in areas around JHSs in Japan, a survey using the direct inspection of a total of 16.3 restaurants (64 restaurants within and 99 outside a 1-km radius from the nearest JHSs) was conducted in May 2003 in Yonago city, Japan. We assessed smoking restriction status in each restaurant and classified them into 2 groups according to the distance from the nearest JHSs. There were only 2 (3.1%) restaurants with 100% nonsmoking and 11 (17.2%) with some partial restrictions among the restaurants within a 1-km radius of JHSs. There were 1 (1.0%) restaurant with 100% non-smoking, 3 (3.0%) with complete non-smoking sections and 17 (17.2%) with some partial restrictions among the restaurants outside a 1-km radius of JHSs. Among restaurants with some partial restrictions, restriction methods were considered insufficient. The smoking restriction status was not significantly different between the restaurant groups within and outside a 1-km radius of JHSs. These results suggest that the public awareness of and attitude toward adolescent smoking problems remains low in Japan. Further SHS control actions for adolescents are needed in Japan.

2006, Tohoku University Medical Press

Lazcano-Ponce E; Benowitz N; Sanchez-Zamorano LM; Barbosa-Sanchez L; Valdes-Salgado R; Jacob P et al. Secondhand smoke exposure in Mexican discotheques. Nicotine & Tobacco Research 9(10): 1021-1026, 2007. (30 refs.)

This study describes the impact of exposure to secondhand smoke for subjects who spend time in a discotheque, by comparing within-subject baseline and postexposure urinary cotinine levels. A total of 100 nonsmoking volunteers from a central region of Mexico provided a urine sample before entering a discotheque and another sample an average of 6 hr after the end of exposure. Concentrations of cotinine and its metabolite, trans-3'-hydroxycotinine, were measured in the urine by liquid chromatography-mass spectrometry. In females the average preexposure level of urinary cotinine was 2.2 ng/ml, and the average postexposure level was significantly higher, at 15.7 ng/ml. In males the average preexposure level of cotinine was 3.7 ng/ml, compared with 49.1 ng/ml in the postexposure assessment. The highest postexposure values were found in men younger than 22 years old with a value of 469.5 ng/ml. Exposure to secondhand smoke is a serious health risk. Our findings are important given that many of our subjects were exposed to substantial amounts of secondhand smoke in discotheques, as evidenced by the high urinary cotinine and 3'-hydroxycotinine concentrations. These findings support the need to prohibit smoking in discotheques to protect nonsmokers' health.

Lee DW; Park HS; Lee TS; Kim MK; Kim YH. Korean working adults' and undergraduates' attitudes towards, and self-efficacy in, joining drinking parties. Social Behavior and Personality 34(5): 487-497, 2006. (32 refs.)

This study compared Korean working adults' participation in drinking parties with work colleagues, with Korean undergraduates' participation in drinking parties with fellow students, to examine if being employed versus being an undergraduate had effects on alcohol consumption. Findings showed that working adults had lower levels of self-efficacy in their drinking-party participation than did undergraduates, and that working adults were less positive about their decision not to join drinking parties than were undergraduates. These findings may imply a generation difference between working adults and undergraduates and also social influence reflected in the Korean workplace culture.

Legrand FD; Goma-I-Freixanet M; Kaltenbach ML; Joly PM. Association between sensation seeking and alcohol consumption in French college students: Some ecological data collected in "open bar" parties. Personality and Individual Differences 43(7): 1950-1959, 2007. (30 refs.)

Numerous factors have been associated with alcohol drinking among college students. Typically, the psychological trait of sensation seeking, has been found to be correlated with alcohol consumption in various populations. Nevertheless, there is a pressing need for more observational and ecological studies of college drinking behavior in unusual and incentive situations. The present study examined the relationship between sensation seeking and blood-alcohol concentration at the end of an "open bar" party in a sample of college students. Our results support the relationship between disinhibition and blood-alcohol concentration among women. In men however, experience seeking was found to be of equal significance than disinhibition. As the sensation seeking ratings were especially high for both sexes as compared to the population norms, the possibility that open bar participants share a specific profile of personality is discussed.

Lenk KM; Toomey TL; Erickson DJ. Propensity of alcohol establishments to sell to obviously intoxicated patrons. Alcoholism: Clinical and Experimental Research 30(7): 1194-1199, 2006. (8 refs.)

Background: Although it is illegal to sell alcohol to an individual who appears obviously intoxicated, several recent studies show that the propensity of these types of sales is high. Our study further assesses the propensity of alcohol establishments to sell alcohol to obviously intoxicated patrons. In addition to providing more recent data (2001) on pseudo-intoxicated purchase attempts at Midwestern on-premise establishments, our study examines the association between establishment policies/practices and the likelihood of sales to intoxicated patrons. Method: We hired professional actors to feign intoxication while attempting to purchase alcohol (pseudo-intoxicated patrons) at 231 bars and restaurants, and we conducted a phone survey of owners/managers of each establishment. Our dependent variable was purchase attempt outcome (alcohol sold vs not sold). Our independent variables included policies/practices of establishments and characteristics of buyers/servers, establishments, and neighborhoods. Results: Pseudo-intoxicated patrons were able to purchase alcohol in 65% of their attempts. Multivariate analyses showed the following: (1) compared with establishments with beer- and/or wine-only licenses, establishments with full liquor licenses were less likely to sell to intoxicated patrons; (2) establishments with average length of employment among managers of at least 1 year were more likely to sell to obviously intoxicated patrons; and (3) establishments that held staff meetings at least once a month were less likely to sell to obviously intoxicated patrons. Neighborhood characteristics were not associated with our outcome in multivariate analyses. Conclusions: Our findings provide increased evidence of the need to address the illegal sale of alcohol to intoxicated patrons, particularly given that increased intoxication levels among patrons resulting from these types of sales can lead to alcohol-related problems.

Livingston M; Chiiuutzhs T; Room R. Changing the density of alcohol outlets to reduce alcohol-related problems. Drug and Alcohol Review 26(5): 557-566, 2007. (71 refs.)

Increasingly, it seems, legal and political debates regarding the granting of new liquor licences are turning to the issue of whether the number and density of alcohol outlets makes a difference in rates of alcohol consumption and alcohol-related harm. But what is the state of the evidence on this question? In this Harm Reduction Digest Livingston, Chikritzhs and Room review the research literature on the effects of density of alcohol sales outlets on alcohol consumption and alcohol-related problems; suggest a new way of conceptualising the relationships; and discuss the implications for reducing alcohol-related harm.

Lund I. Drinking on the premises in Norway: Young adults' use of public drinking places. Addictive Behaviors 32(12): 2737-2746, 2007. (18 refs.)

In this paper various aspects of young adults' use of premises licensed to sell alcoholic beverages are discussed. Data were obtained from national surveys of drinking habits in 1999 and 2004 (SIRUS), and the age group was 18 to 34 years. Bivariate methods showed a positive association between drinking in licensed premises and both alcohol consumption and frequency of intoxication. Frequent users of licensed premises had more often had both positive experiences (felt more optimistic or popular) and negative experiences (arguments or fights and symptoms of hangover) related to their drinking. Results from a log-linear regression analysis showed that although some demographic groups tended to be intoxicated more often (men, younger people, single people and people without higher education), frequency of drinking in licensed premises had a strong positive effect on frequency of intoxication.

Macdonald S; Cherpitel CJ; DeSouza A; Stockwell T; Borges G; Giesbrecht N. Variations of alcohol impairment in different types, causes and contexts of injuries: Results of emergency room studies from 16 countries. Accident Analysis and Prevention 38(6): 1107-1112, 2006. (29 refs.)

Objective: The purpose of this paper is to document alcohol impairment (based on a blood alcohol content (BAC) of at least 80 mg%) for different types, causes and location contexts of injuries. Design and setting: Data from 45 studies with 11,536 injury patients were merged to determine variations in the percent of alcohol impairment among injury patients. In each study, emergency room (ER) injury patients were given a short interview on the circumstances of their injury and BAC was measured. Results: Injury severity, measured by number of body regions injured was significantly associated with BACs over 80 mg%. The highest percentage of injury type to involve alcohol was head injury/concussion. In terms of causes of injuries, patients with alcohol impairment were significantly more likely to be involved in violence than any other cause (i.e., vehicle, failing, poisoning or burns). Finally, injuries occurring at a bar or restaurant were significantly more likely to involve alcohol impairment than any other setting. Conclusions: The results demonstrate considerable variation in the circumstances where alcohol is involved in injuries. These results may be useful for the development of prevention initiatives

2006, Elsevier Science

Martinez JA; Rutledge PC; Sher KJ. Fake ID ownership and heavy drinking in underage college students: Prospective findings. Psychology of Addictive Behaviors 21(2): 226-232, 2007. (25 refs.)

The authors examined the ownership of false identification (fake ID) for the purpose of obtaining alcohol and the relation of fake ID ownership to heavy drinking in a longitudinal sample of college students under 21 years of age. A sample of 3,720 undergraduates was assessed the summer prior to college entrance and during the 4 semesters comprising freshman and sophomore years. Regression analyses were used to estimate bidirectional relations between consumption and fake ID ownership. Sex, Greek membership, and prior drinking were controlled. Results showed that fake ID ownership increased over time (12.5% precollege to 32.2% fourth semester) and that Greek members were more likely than others to own fake IDs. Fake ID ownership predicted concurrent and next-semester heavy drinking with increasing strength over time. Also, the acquisition (onset) of fake ID ownership at each time point was predicted by previous-semester consumption. When traditional, robust risk factors of consumption are controlled, fake ID ownership meaningfully relates to heavy drinking in college. It thus presents a significant public health problem, addressable through training for alcohol servers and retailers, punitive measures toward fake ID owners, and other possible interventions.

McCambridge J; Mitcheson L; Hunt N; Winstock A. The rise of Viagra among British illicit drug users: 5-year survey data. Drug and Alcohol Review 25(2): 111-113, 2006. (10 refs.)

Viagra use among British nightclubbers, a sentinel population of illicit drug users, was first reported in 1999. There has since been little attention paid to the evolution of patterns of non-prescribed use, apart from among men who have sex with men. Beginning in 1999 an annual survey has been conducted with a specialist dance music magazine, permitting cross-sectional comparisons over time. Rising levels of lifetime and current use prevalence and data on patterns of both male and female use are reported, along with elevated prevalence levels among both gay men and women. Experimentation with Viagra appears increasingly to have become established among British nightclubbers who use recreational drugs. Ethnographic and epidemiological study and monitoring of adverse consequences is now needed to fully appreciate reasons for use and the extent of possible harms.

Metsios GS; Flouris AD; Jamurtas AZ; Carrillo AE; Kouretas D; Germenis AE et al. A brief exposure to moderate passive smoke increases metabolism and thyroid hormone secretion. Journal of Clinical Endocrinology and Metabolism 92(1): 208-211, 2007. (20 refs.)

Context: Active smoking influences normal metabolic status and thyroid function. Objective: The objective was to assess experimentally the effects of 1 h of moderate passive smoking in a controlled simulated bar/restaurant environment on the metabolism and thyroid hormone levels in healthy nonsmokers. Participants: Eighteen ( nine females, nine males) healthy individuals ( mean +/- SD: age, 25.3 +/- 3.1 yr; height, 174.0 +/- 10.1 cm; weight, 65.2 +/- 13.7 kg) participated in the study. Design: In repeated- measures randomized blocks, participants visited the laboratory on 2 consecutive days. In the experimental condition, they were exposed to 1 h of moderate passive smoking at a carbon monoxide concentration of 23 +/- 1 ppm in an environmental chamber, whereas in the control condition participants remained in the same chamber for 1 h breathing normal atmospheric air. Main Outcome Measures: In both conditions, cotinine serum and urine levels, resting energy expenditure ( REE), as well as concentration of T-3, free T-4, and TSH were assessed before participants entered the chamber and immediately after their exit. Heart rate and blood pressure were tested in 10-min intervals during all REE assessments. Results: The mean +/- SD difference of serum and urine cotinine levels ( - 0.27 +/- 3.94 vs. 14.01 +/- 6.54 and 0.05 +/- 2.07 vs. 7.23 +/- 3.75, respectively), REE ( 6.73 +/- 98.06 vs. 80.58 +/- 120.91) as well as T3 and free T-4 ( 0.05 +/- 0.11 vs. 0.13 +/- 0.12 and 0.02 +/- 0.15 vs. 0.22 +/- 0.20) were increased in the experimental compared with the control condition at baseline and follow- up ( P < 0.05). No statistically significant variation was observed in the mean difference of the remaining parameters ( P > 0.05). Serum and urine cotinine values were linearly associated with REE ( P < 0.05). Conclusion: One hour of passive smoking at bar/restaurant levels is accompanied by significant increases in metabolism and thyroid hormone levels.

2007, Endocrine Society

Meyers S; Stuart SJ. Practice tips: Local regulation of alcohol licensees. Los Angeles Lawyer 29: 14, 2006. (46 legal refs.)

In California, the regulatlry authority for alcohol sales, consumption, production, and transportation is vested in the Department of Alcoholic Beverage Control, which has the responsibility for the issuance of liquor licenses and the regulation of existing licensees. As authorized under the Twenty-first Amendment to the U.S. Constitution, the California Legislature has created a comprehensive regulatory environment governing all aspects of alcoholic beverage sales and services, but the role of local government in preventing the deleterious effects of alcohol sales and consumption is less defined. This article examines what local governemnt can do to mitigate social, economic, and criminal consequences of alcohol use within the confines of a preemptive state regulatory scheme. There is a review of court cases which have been significant in defining the limits in the execution of state authority. For example, the Department may only grant a license if it determines that the license will not be contrary to the "public welfare or morals." Also the Department is precluded from issuing a license that is contrary to a valid local zoning regulation. In addition, Courts have held that the Department has a "solemn responsibility" to protect the public from the potential harms that coincide with the sale of liquor. The department may also deny a license if issuance of the license would result in or add to an "undue concentration" of licenses. An undue concentration exists when an "applicant's premises are located in a crime reporting district that has a 20 percent greater number of Reported Crimes...than the average number of reported crimes as determined from all the crime Reporting Districts within the jurisdiction" or when the census tract in which the applicant's store is located "exceeds the ratio of on sale retail licenses to population in the county in which the applicant premises are located." Also denial is possible if the issuance of a license would tend to create a law enforcement problem. Cities can take a strategic approach to managing alcohol availability through land use controls and zoning regulations. Thus, local governments can impose density restrictions that limit alcohol availability by population or geographic area. Another option is to implement zoning restrictions.

Milz S; Akbar-Khanzadeh F; Ames A; Spino S; Tex C; Lanza K. Indoor air quality in restaurants with and without designated smoking rooms. Journal of Occupational and Environmental Hygiene 4(4): 246-252, 2007. (18 refs.)

Indoor air quality in restaurants was studied in two cities in northwest Ohio after clean indoor air ordinances had been enacted. Carbon dioxide and ultrafine particles were measured in two restaurants in Toledo and two restaurants in Bowling Green. One restaurant in each city was smoke free, and one restaurant in each city contained a dedicated smoking room. A smoke free office space was also assessed as a reference site. Measurements were collected with datalogging instrumentation simultaneously in both the designated smoking room, if present, and in the nonsmoking section. For smoke free establishments, datalogging instrumentation was also used. Carbon dioxide levels were elevated in all four restaurants, with only 32% of the measurements meeting the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) criterion level of 1000 ppm. Ultrafine particles currently do not have any formal standard or guideline. Statistically significant differences were evident between all four restaurants and the reference site. The largest differences were found between the two designated smoking rooms and the reference site (p < 0.001), with the mean levels in the smoking rooms up to 43 times higher than in the reference site. The results from this study indicate inadequate fresh air supply in all four restaurants, particularly in the designated smoking rooms, and the possibility that the designated smoking rooms were not containing the environment tobacco smoke, based on the ultrafine particle concentrations measured in the nonsmoking areas of the smoking restaurants.

Moore RS; Lee JP; Antin TMJ; Martin SE. Tobacco free workplace policies and low socioeconomic status female bartenders in San Francisco. Journal of Epidemiology and Community Health 60(Supplement 2): 51-56, 2006. (24 refs.)

Study objective: Multiple studies have found that, compared with employees in other settings, workers in bars and restaurants have been exposed to high levels of secondhand smoke, putting them at increased risk for health complications. Among these bar employees are many women of low socioeconomic status (SES). Smoke free workplace ordinances have been extended to bars and restaurants in cities and states throughout the USA; some bars, however, continue to be out of compliance with these laws. The objective of this study is to assess the relation between bartender gender and smoke free workplace compliance in bars. Design: This paper reports on analyses of observational data on compliance with smoke free workplace policy in 121 randomly selected bars together with qualitative data from semi-structured interviews with bartenders and patrons in bars. Setting: San Francisco County bars. Main results: Findings from this research showed that smoke free policy non-compliance was associated with bars in which women were bartenders, increasing their tobacco exposure compared with male bartenders. In interviews, although some female bartenders expressed ambivalence toward the smoke free ordinance, many others described experiencing positive health and social consequences when the bars in which they worked could eliminate interior smoking. Conclusions: The analyses presented here shed light on the benefits of improving the workplace environment for low SES female bartenders through the extension of strong smoke free workplace policies to all workplaces, including bars.

Ngai SSY; Ngai NP; Cheung CK. Environmental influences on risk taking among Hong Kong young dance partygoers. Adolescence 41(164): 739-752, 2006. (46 refs.)

This study investigates risk-taking behavior and its associated factors among young Hong Kong partygoers at rave parties or discos. Based on a survey of 300 14 to 28-year-old dance partygoers recruited by outreaching social workers, the study provides data on risks in terms of the likelihood of drug abuse, coitus, unprotected coitus, fighting, and high-speed driving among the young people. Furthermore, it examines factors related to the dance party, together with a set of background factors on the partygoer's report of the chance of engaging in risky behavior as expected in the coming six months. Factors related to the dance party include the location (Hong Kong and Mainland China), fees, number of partners, dancers, police inspection, drug supply, drug sales, injuries, coitus, fighting, drug abuse, and environmental factors. The environmental factors are the availability of first aid, fire extinguishing, and drinking water facilities, light and audio effects, ventilation, drug circulation, underage admission, sex partners, fighting, and low-price beer. Implications of present findings for social policy and future research are discussed.

2006, Libra Publishers

Osterberg E. What Are the Most Effective and Cost-Effective Interventions In Alcohol Control?. Copenhagen: World Health Organization, Regional Office for Europe, 2004. (24 refs.)

The issue: Europe plays a significant role in the production, trade and consumption of alcoholic beverages; it also carries a heavy social and economic burden of alcohol-related problems. Alcohol consumption is estimated to be responsible for about 10% of the total disease burden, increasing the risk of liver cirrhosis, certain cancers, high blood pressure, stroke and congenital malfunctions, among other problems. Furthermore, it increases the risk of many social problems such as family disintegration, absenteeism, poor productivity, financial hardships, unintentional injuries, traffic accidents, criminal behaviour, violence, homicide and suicide. Findings: There is substantial evidence showing that an increase in alcohol prices reduces consumption and the level of alcohol-related problems. In most countries and especially in countries with low alcohol tax rates, tax-induced price increases on alcohol beverages lead to increases in state tax revenues and decreases in state expenses related to alcohol-related harms. The effects of price increases, like the effects of other alcohol control measures, differ among countries, depending on such factors as the prevailing alcohol culture and public support for stricter alcohol controls. However, the effects on alcohol-related harms are definite and the costs low, making it a cost-effective measure. In addition, stricter controls on the availability of alcohol, especially via a minimum legal purchasing age, government monopoly of retail sales, restrictions on sales times and regulations of the number of distribution outlets are effective interventions. Given the broad reach of all these measures, and the relatively low expense of implementing them, they all are highly cost-effective. Furthermore, most measures against drunk-driving, such as sobriety check points, random breath testing, lowered blood alcohol concentration limits, suspension of driver's licenses, graduated licensing for novice drivers, and brief interventions for hazardous drinkers also receive high effectiveness ratings. There is good research support for these drunk-driving interventions. Thus these interventions are applicable in most countries and are relatively inexpensive to implement and sustain. Server liability and enforcement of on-premise regulations combined with community mobilization seem to be strategies with some impact without being too costly. However, they do not reach offpremise drinking. Server training in responsible beverage service is unlikely to have an effect if it is not backed by the threat of suspending the licenses of those who continue to serve underage drinkers or intoxicated patrons. If youthful drinking is seen as a specific alcohol policy problem, increasing the legal age limit for purchasing or selling alcoholic beverages is the most immediate and effective measure. Various educational approaches have been developed to reduce alcohol consumption. Although they are growing in popularity, there is little evidence of their effectiveness. Similarly, current research findings only show limited effects both on advertising and advertising bans.

Paschall MJ; Saltz RF. Relationships between college settings and student alcohol use before, during and after events: A multi-level study. Drug and Alcohol Review 26(6): 635-644, 2007. (9 refs.)

Introduction and Aims. We examined how alcohol risk is distributed based on college students' drinking before, during and after they go to certain settings. Design and Methods. Students attending 14 California public universities (N = 10 152) completed a web-based or mailed survey in the fall 2003 semester, which included questions about how many drinks they consumed before, during and after the last time they went to six settings/events: fraternity or sorority party, residence hall party, campus event ( e. g. football game), off-campus party, bar/restaurant and outdoor setting ( referent). Multi-level analyses were conducted in hierarchical linear modeling (HLM) to examine relationships between type of setting and level of alcohol use before, during and after going to the setting, and possible age and gender differences in these relationships. Drinking episodes ( N 24 207) were level 1 units, students were level 2 units and colleges were level 3 units. Results. The highest drinking levels were observed during all settings/events except campus events, with the highest number of drinks being consumed at off-campus parties, followed by residence hall and fraternity/sorority parties. The number of drinks consumed before a fraternity/sorority party was higher than other settings/events. Age group and gender differences in relationships between type of setting/event and 'before,' 'during' and 'after' drinking levels also were observed. For example, going to a bar/restaurant ( relative to an outdoor setting) was positively associated with 'during' drinks among students of legal drinking age while no relationship was observed for underage students. Discussion and Conclusions. Findings of this study indicate differences in the extent to which college settings are associated with student drinking levels before, during and after related events, and may have implications for intervention strategies targeting different types of settings.

Peltzer K; Ramlagan S; Gliksman L. Responsible alcoholic beverages sales and services training intervention in Cape Town: A pilot study. Journal of Psychology in Africa; South of the Sahara, the Caribbean, & Afro-Latin America 16(1): 45-52, 2006. (28 refs.)

The aim of this study was to pilot a responsible beverage service intervention in order to reduce alcohol-impaired road use. The sample included 20 shebeens including 10 licensed and 10 unlicensed establishments chosen from a list of alcohol serving establishments in Gugulethu, Cape Town. The study examined whether changes in knowledge, attitudes, and behaviour of servers as well as BAC levels of patrons occurred as a result of receiving server intervention training. Results indicate that the training programme was effective in changing serving practices consistent with the techniques and strategies emphasized in the training. However, the breathalyser results for baseline and follow-up, respectively, in the intervention and control group did not show differences among patrons. It is recommended that mandatory server training be introduced in South Africa for licensed establishments and develop an incentive system to encourage voluntary use of server training for unlicensed establishments.

Perham N; Moore SC; Shepherd J; Cusens B. Identifying drunkenness in the night-time economy. Addiction 102(3): 377-380, 2007. (4 refs.)

Background: Prohibiting the sale of alcohol to intoxicated patrons by licensees and their staff requires definitions of drunkenness. Aim: To assess the relationship between blood alcohol concentration (BAC) and indicators used in field sobriety tests putatively associated with intoxication. Design, participants, setting, material and methods: A random sample of 314 female and 579 male city centre drinkers. Surveyors scored respondents' and non-respondents' gait, eyes and speech for signs of drunkenness as well as their drunkenness on a 10-point Likert scale. Breath analysis was used to determine respondents' BAC. Findings: Combinations of slurred speech, staggering gait and glazed eyes significantly predicted levels of BAC with a staggering gait indicating highest levels of intoxication. Conclusions: Subjective ratings of drunkenness by trained observers corresponded with BAC. Transition BACs denoting observable behaviour change associated with intoxication have been identified. Observations of gait, combined with assessment of slurred speech should be the basis of estimates of drunkenness.

Plant M; Plant M. Binge Britain: Alcohol and the national response. Oxford: Oxford University Press, 2006. (605 refs.)

This book discusses alcohol use in Britain. The use of "binge" in the title is a bit confusing, as the authors in their preface have some criticisms of the widespead and often contradictory ways in which the term is used, i.e. if a "binge" is synonymous with an occassion that may encompass a whole day versus severall hours, the likely related dangers and feeling states are quite different. The book is organized into seven chapters with an appended bibliography. The first chapter describes the use of alcohol over historical periods dating back to the Roman conquest, but focusing largely upon the periods from the Tudors and Stuarts. Chapter 2 considers the current drinking patterns and trends, with comparisons to other nations. Chapter 3 deals with problems related on alcohol use, considering both health consequences and social problems. Chapter 4 discusses alcohol policy. Chapter 5 examines some of the recent controversies around alcohol policy, including the changes in licensing allowing extended hours in bars, the media response, the response of police, and public opinion. Chapter 6 addresses "Lessons from the past." It looks to earlier periods in which licensing standards were eaased, as well as the experiences of other countries. Chapter 7 considers alternative and future policy initiatives, from restricting access of young people to alcohol, to tax policy, to drinking and driving, community action inititives, and ways of working with the beverage industry.

Purcell J; Graham K; Gliksman L; Tessier C; Jelley J. Redesign on the fly: Safer Bars and the Toronto experience. Nordic Studies on Alcohol and Drugs 20(English Supplement): 155-160, 2003. (9 refs.)

This is one of 15 papers on particular projects. This paper describes the experience and lessons learned at the 18-month mark of the Safer Bars project, a three-year randomised control evaluation of to reduce bar violence. The evaluation strategy is described, from its first formulation to major changes introduced after working with bar owners and their staff. Of note was the relative absence of violence in large-capacity licensed (Toronto) bars originally targeted as potential research site -- attributed to well-trained staff, rise of the rave scene with reduced drinking with the synthetic drug use and presence of marijuana use, a diverse culturally tolerant clientele. The process of recruiting bars and incentives used are discussed.

Pyles MK; Mullineaux DJ; Okoli CTC; Hahn EJ. Economic effect of a smoke-free law in a tobacco-growing community. Tobacco Control 16(1): 66-68, 2007. (17 refs.)

Objective: To determine whether Lexington, Kentucky's smokefree law affected employment and business closures in restaurants and bars. On 27 April 2004, Lexington-Fayette County implemented a comprehensive ordinance prohibiting smoking in all public buildings, including bars and restaurants. Lexington is located in a major tobaccogrowing state that has the highest smoking rate in the US and was the first Kentucky community to become smoke-free. Design: A fixed-effects time series design to estimate the effect of the smoke-free law on employment and ordinary least squares to estimate the effect on business openings and closings. Subjects and settings: All restaurants and bars in LexingtonFayette County, Kentucky and the six contiguous counties. Main outcome measures: ES-202 employment data from the Kentucky Workforce Cabinet; Business opening/ closings data from the Lexington-Fayette County Health Department, Environmental Division. Results: A positive and significant relationship was observed between the smoke-free legislation and restaurant employment, but no significant relationship was observed with bar employment. No relationship was observed between the law's implementation and employment in contiguous counties nor between the smoke-free law and business openings or closures in alcohol-serving and or non-alcohol-serving businesses. Conclusions: No important economic harm stemmed from the smoke-free legislation over the period studied, despite the fact that Lexington is located in a tobacco-producing state with higher-than-average smoking rates.

Rajaraman I. Impact of liquor taxation on consumption patterns in India. Journal of Policy Modeliing 29(2): 195-207, 2007. (20 refs.)

The paper fits an ordered logit specification to primary data from a rural survey of Karnataka state in India in 2003-2004, to determine whether ease of access to liquor has a statistically significant impact on the probability of a rural household consuming liquor, further classified into occasional and daily consuming households. The inbuilt incentive in the present design of liquor taxation in the state for promoting rural access to liquor motivates the study. It is important that the struggle for fiscal resources to reach the Millennium Development Goals should not be achieved at the expense of the state becoming a partner in promoting the consumption of a potentially addictive substance.

Reiling DM; Nusbaumer MR. An exploration of the potential impact of the designated driver campaign on bartenders' willingness to over-serve. International Journal of Drug Policy 18(6): 458-463, 2007. (30 refs.)

Much has been written about the impact of the presence of a designated driver on patrons' consumption, but heretofore, its impact on the behaviour of the server has been virtually ignored. The goal of this paper, then, was to explore the potential impact of the presence of a designated driver on alcoholic beverage servers' self-reported willingness to knowingly serve an already intoxicated customer. chi(2) analysis of survey data collected from 938 licensed servers, in the state of Indiana, USA, was performed. Approximately 43% of the bartenders surveyed reported that they either would be or might be willing to over-serve an already intoxicated customer. Of those who answered the follow-up question as to under what conditions they would be willing to over-serve, almost 80% reported that they would do so if the patron were accompanied by a designated driver. The statistical significance of the relationship between these two variables (.000) raises the question of whether the Designated Driver Campaign has the latent function of enabling some servers to neutralize their responsibility for over-serving by disregarding other types of intoxication-related harm.

Reiling DM; Nusbaumer MR. When problem servers pour in problematic places: Alcoholic beverage servers' willingness to serve patrons beyond intoxication. Substance Use & Misuse 41(5): 653-668, 2006. (52 refs.)

Our objective was to examine alcoholic beverage servers' willingness to over-serve as an explanation for intoxication that occurs in drinking establishments. Survey data were collected in 2000 from 911 alcoholic beverage servers in the State of Indiana, USA, with a grant from Indiana University. Chi-squared, analysis of variance, and step-wise regression were used to examine the influence of personal factors, location factors, management policies and practices, and larger societal control efforts on willingness to over-serve. Our findings support the need to examine managements' economic motivation and servers' personal drinking patterns as motivations for serving beyond intoxication in future research.

Repace J; Hughes E; Benowitz N. Exposure to second-hand smoke air pollution assessed from bar patrons' urinary cotinine. Nicotine & Tobacco Research 8(5): 701-711, 2006. (19 refs.)

We used physical and pharmacokinetic modeling to estimate personal exposures to respirable particle ( RSP) and carcinogenic particulate polycyclic aromatic hydrocarbon (PPAH) air pollution from second-hand smoke (SHS) from the increase in urinary cotinine of eight patrons of three bars in Bismarck, North Dakota. We compared SHS-RSP levels to the U.S. Air Quality Index (AQI), used to forecast outdoor air pollution conditions. We measured smoker density and air exchange rates to generalize our results. Urinary cotinine increased by an average of 4.28 ng/ml to 6.88 ng/ml to 9.55 ng/ml above preexposure background from 6-hr exposures in the three bars. Corresponding estimated SHS-RSP levels were, respectively, 246 mg/m (3), 396 mg/m (3), and 549 mg/m (3), comparable to those measured in 6 Wilmington, Delaware, bars and in 14 western New York bars. Estimated personal SHS-RSP air pollution exposures for the eight subjects, when converted to the 24-hr averaging time of the AQI, were "code red'' (unhealthy). Measured outdoor air quality RSP levels for the same period were 1%-3% of the indoor RSP levels in the three bars, and were AQI "code green'' (healthy). Estimated SHS-PPAH levels were comparable to peak 3-hr PPAH levels reported at a highway tollbooth. Bismarck cotinine-estimated SHS-RSP varied with smoker density, as did measured SHS-RSP levels in smoking bars in Delaware and New York. Our results show that smoking in bars produces levels of personal air pollution for bar patrons that merit air pollution alerts when sustained in the outdoor air.

Romley JA; Cohen D; Ringel J; Sturm R. Alcohol and environmental justice: The density of liquor stores and bars in urban neighborhoods in the United States. Journal of Studies on Alcohol 68(1): 48-55, 2007. (37 refs.)

Objective: This study had two purposes: (1) to characterize the density of liquor stores and bars that individuals face according to race, economic status, and age in the urban United States and (2) to assess alternative measures of retailer density based on the road network and population. Method: We used census data on business counts and sociodemographic characteristics to compute the densities facing individuals in 9,361 urban zip codes. Results: Blacks face higher densities of liquor stores than do whites. The density of liquor stores is greater among nonwhites in lower-income areas than among whites in lower- and higher-income areas and nonwhites in higher-income areas. Nonwhite youths face higher densities of liquor stores than white youths. The density of liquor stores and bars is lower in higher-income areas, especially for nonwhites. Conclusions: Mismatches between alcohol demand and the supply of liquor stores within urban neighborhoods constitute an environmental injustice for minorities and lower-income persons, with potential adverse consequences for drinking behavior and other social ills. Our results for bars are sensitive to the measure of outlet density as well as population density. Although neither measure is clearly superior, a measure that accounts for roadway miles may reflect proximity to alcohol retailers and thus serve as a useful refinement to the per-capita measure. If so, alcohol policy might also focus on density per roadway mile. Further research on the existence, causes, and consequences of environmental injustice in alcohol retailing is warranted.

2007, Alcohol Research Documentation

Salasuo M. Partying and drug use in Helsinki, Liverpool and Tallin. Nordic Studies on Alcohol and Drugs 22(English Supplement): 133-134, 2005. (1 refs.)

This commentary serves as an introduction to three articles which follow, dealing with the nightlife and political response. There is an effort to identify trends in drug use and drinking, the culture, hisotry and policies of each city. Also there is an effort to consider the emergence of a youth culture which transcends municipalities and countries.

Salasuo M; Seppala P. The party scene of Helsinki. Nordic Studies on Alcohol and Drugs 22(English Supplement): 142-145, 2005. (11 refs.)

This is one of three articles dealing with the nightlife and political response in different countries. The goal is to identify trends in drug use and drinking, the culture, history and policies of each city. These articles also attend to the emergence of a youth culture which transcends municipalities and countries. The focus of this article is Helsinki, giving an introduction to the nature of partying and use of intoxicants, with a comment on preventive measures aimed at reducing harms and risks related to alcohol and drug use. Compared to other cities, the nightlife of Helsinki evolved more slowly. In part this is attributed to the strong regulatory environment. In the early 1990s there was a smaller underground club culture, but it was only in the later part of the decade that the number of bars and cafes increased. The earlier club culture merged into the regular night clubs. In terms of substance use, alcohol is the major substance, but cannabis use is becoming "normalized" in the sense of its not being stigmatizing among young people, and its being discussed more openly. GHB use has dropped in popularity since its being made illegal in 2001. Cocaine use, which had been part of the more affluent club set, has declined and to an extent been replaced by ecstasy and amphetamine. The article concludes with a discussion of the factors which made Finland last in the emergency of the club scene, in terms of cultural norms.

Schalow P. Dangerous pleasure: The discource of drink in early modern Japan. IN: Umesao T; Yoshida S; Schalow P, eds. Japanese Civilization in the Modern World. XVIII, Alcoholic Beverages. Senri Ethnological Studies no. 64. Osaka Japan: National Museum of Ethnology (Japan), 2003. pp. 77-88. (6 refs.)

This chapter considers the role of sake drinking in the 17th century, the point at which discussion of the dangers and pleasures first emerged. Some of the earliest writings were essentially philosophical debates, for example, with recitation of the 15 virtues or 15 detrimental aspects. Another debate focused on the the relative merits of tea versus sake, and whether their use was comparible. Another such debate addressed the impact on male love and female love.

Scribner R; Mason K; Theall K; Simonsen N; Schneider SK; Towvim LG. The contextual role of alcohol outlet density in college drinking. Journal of Studies on Alcohol and Drugs 69(1): 112-120, 2008. (29 refs.)

Objective: The objective of the study is to examine the relationship between the physical availability of off-campus alcohol and drinking outcomes among college students. Method: A multilevel analysis of students (N = 17,051) nested within college campuses (N = 32) was conducted. Four problem-drinking-related outcomes (i.e., average number of drinks when partying, frequency of drunkenness in past 2 weeks, 30-day frequency of drinking, and greatest number of drinks in one sitting) along with individual level covariates of drinking were introduced at the student level. The physical availability of alcohol was assessed as the number of on-premise and off-premise alcohol outlets within 3 miles of campus per 1,000 students enrolled. Results: Higher densities of on-premise alcohol outlets were strongly related to drinking outcomes even after controlling for individual predictors of college drinking. The association indicated that the campus means for the average number of drinks when partying and the number of drinking occasions in the past 30 days were, respectively, 1.13 drinks and 1.32 occasions greater when the outlet density was 2 SDs higher. Conclusions: Off-campus, on-premise outlet density is strongly associated with college-drinking outcomes. Given the limited number of modifiable factors that affect college drinking, on-premise outlet density represents a potential modifiable means of addressing the problem.

Scribner R; Theall KP; Ghosh-Dastidar B; Mason K; Cohen D; Simonsen N. Determinants of social capital indicators at the neighborhood level: A longitudinal analysis of loss of off-sale alcohol outlets and voting. Journal of Studies on Alcohol and Drugs 68(6): 934-943, 2007. (65 refs.)

Objective: Neighborhoods represent a unique level of analysis where social and material determinants of social capital may be lodged. The 1992 civil unrest in Los Angeles following the Rodney King verdict provided an opportunity to determine if a change in the material environment (i.e., the loss of off-sale alcohol outlets) resulted in a subsequent change in a potential indicator of social capital-civic engagement-as measured by voting rates. Method: Longitudinal analyses of voting rates between 1990 and 1996 for the 480 census tracts affected by the civil unrest were conducted. Tracts that lost and did not lose off-sale alcohol outlets were compared using piecewise hierarchical models that accounted for both time-varying and census-tract-level confounders, as well as for spatial autocorrelation. Results: In the post-unrest period, the increase in voting was significantly greater in tracts where there was a loss of alcohol outlets (P = 0.393, p <.05). Findings remained after taking into account time-varying effects of the changes in ethnicity, gender, and age; and baseline effects of voting, potential for social organization, outlet density, and deprivation. The loss of alcohol outlets was associated with an average 3.0% increase in voting rate in the post-unrest period, translating into an average increase of 50212 voters per tract, depending on the size of the tract. Conclusions: Loss of off-sale alcohol outlets in the 1992 civil unrest was associated with increased voting at the census tract level. Findings support the concept that loss of alcohol outlets in the neighborhood environment may contribute to the development of social capital, possibly through social network expansion.

Semple S; Creely KS; Naji A; Miller BG; Ayres JG. Secondhand smoke levels in Scottish pubs: The effect of smoke-free legislation. Tobacco Control 16(2): 127-132, 2007. (21 refs.)

Objective: To compare levels of particulate matter, as a marker of secondhand smoke (SHS) levels, in pubs before and 2 months after the implementation of Scottish legislation to prohibit smoking in substantially enclosed public places. Design: Comparison of SHS levels before and after the legislation in a random selection of 41 pubs in 2 Scottish cities. Methods: Fine particulate matter < 2.5 mu m in diameter (PM2.5) was measured discreetly for 30 min in each bar on 1 or 2 visits in the 8 weeks preceding the starting date of the Smoking, Health and Social Care (Scotland) Act 2005 and then again 2 months after the ban. Repeat visits were undertaken on the same day of the week and at approximately the same time of the day. Results: PM2.5 levels before the introduction of the legislation averaged 246 mu g/m(3) (range 8-902 mu g/m(3)). The average level reduced to 20 mu g/m(3) (range 6-104 mu g/m(3)) in the period after the ban. Levels of SHS were reduced in all 53 post-ban visits, with the average reduction being 86% (range 12-99%). PM2.5 concentrations in most pubs post-ban were comparable to the outside ambient air PM2.5 level. Conclusions: This study has produced the largest dataset of pre- and post-ban SHS levels in pubs of all worldwide smoke-free legislations introduced to date. Our results show that compliance with the Smoking, Health and Social Care (Scotland) Act 2005 has been high and this has led to a marked reduction in SHS concentrations in Scottish pubs, thereby reducing both the occupational exposure of workers in the hospitality sector and that of non-smoking patrons.

Skogstad M; Kjaerheim K; Fladseth G; Gjolstad M; Daae HL; Olsen R et al. Cross shift changes in lung function among bar and restaurant workers before and after implementation of a smoking ban. Occupational and Environmental Medicine 63(7): 482-487, 2006. (36 refs.)

Objective: To study possible cross shift effects of environmental tobacco smoke (ETS) on pulmonary function among bar and restaurant employees before and after the implementation of a smoking ban in Norway. Methods: The study included 93 subjects employed in 13 different establishments in Oslo. They were examined at the beginning and end of a workshift both while ETS exposure was present and when smoking was banned. The mean exposure level of nicotine and total dust before the ban was 28 mu g/m(3) (range 3-65) and 275 mu g/m(3) ( range 81-506), respectively. Following the smoking ban, the mean level of nicotine and total dust was 0.6 mu g/m(3) and 77 mu g/m(3), respectively. Assessment of lung function included dynamic lung volumes and flows. Results: The cross shift reduction in forced vital capacity (FVC) among 69 subjects participating in both examinations changed from 81 ml (SD 136) during exposure to ETS to 52 ml (SD 156) (p = 0.24) following the smoking ban. The reduction in forced expired volume in one second (FEV1) during a workshift, was borderline significantly reduced when comparing the situation before and after the intervention, by 89 ml ( SD = 132) compared to 46 ml ( SD = 152) ( p = 0.09), respectively. The reduction in forced mid-expiratory flow rate (FEF25-75%) changed significantly from 199 ml/s ( SD = 372) to 64 ml/s (SD = 307) ( p = 0.01). Among 26 non-smokers and 11 asthmatics, the reduction in FEV1 and FEF25-75% was significantly larger during ETS exposure compared to after the smoking ban. There was an association between the dust concentration and decrease in FEF25-75% before the ban among non-smokers (p = 0.048). Conclusions: This first study of cross shift changes before and after the implementation of a smoking ban in restaurants and bars shows a larger cross shift decrease in lung function before compared with after the implementation of the ban.

Stahler GJ; Mazzella S; Mennis J; Chakravorty S; Rengert G; Spiga R. The effect of individual, program, and neighborhood variables on continuity of treatment among dually diagnosed individuals. Drug and Alcohol Dependence 87(1): 54-62, 2007. (54 refs.)

This study reviewed the medical charts of 271 patients diagnosed with co-morbid mental health and substance-use disorders who were discharged from a hospital acute inpatient unit to various outpatient treatment programs in Philadelphia. Geographic Information Systems (GIS) technology and logistic regression modeling were employed to investigate the effects of individual, neighborhood, and program-level variables on arrival to the first treatment appointment within 30 days of discharge. Four models are presented. The results of the study suggest that having had three or more treatment episodes prior to inpatient hospitalization, and living in a neighborhood in which temporary or transitional, and presumably, other low income housing is located, increased the likelihood of patients continuing with treatment in the community. Discharge to the preadmission address, a chief complaint of bizarre behavior, close proximity of two or more liquor and/or beer stores, a high density of narcotics anonymous (NA) and/or Alcoholics Anonymous (AA) meetings within the neighborhood, an axis I diagnosis of substance-induced mood disorder, and a urine drug screen positive for heroin reduced the likelihood of attending outpatient treatment. We conclude that geographic and community variables as they relate to substance abuse may add an important dimension to our understanding of patient functioning and well being in the community following inpatient treatment.

Swedish National Institute for Public Health. Nordic alcohol statistics 1993-2003. Nordic Studies on Alcohol and Drugs 21(English Supplement): 196-206, 2004

The Swedish National Institute for Public Health with the cooperation of the Finnish National Research and Development Centre has collected statistical data of alcohol, retail outlets, licensed premises, deaths caused by alcohol, and cases of drunken driving for the Nordic countries. Unregisted consumption is obviously excluded, but is estimated in Sweden and Finland to be between 15-30% of registered consumption. In terms of consumption, there is marked variaiton with Greenland the highest at a 12.3 litres per capita consumption for those age 15 and older, and Norway has the lowest at 5.89 litres per capita, age 15 and older. Over time, consumption remained stable in Denmark and Greenland between 1993 and 2002, however, theer was an increase in Finland, Iceland, Sweden and Norway. Data on consumption of different types of bevearges in each country are reported. In terms of cost, the price has declined in all countries, and state revenues from alcohol similarly decreased. In respect to morbidity and mortality, Finland has the highest number of deaths from alcohol poisoning (acute use) as well as with Denmark having the highest rate of deaths fromm cirrhosis. Data is presented in 11 figures and tables.

Thomson G; Wilson N. One year of smokefree bars and restaurants in New Zealand: Impacts and responses. BMC Public Health 6: article 64, 2006. (73 refs.)

Background: New Zealand introduced a smokefree bars and restaurants policy in December 2004. We reviewed the data available at December 2005 on the main public health, societal and political impacts and responses within New Zealand to the new law. Methods: Data were collected from publicly available survey reports, and from government departments and interviews. This included data on smoking in bars, attitudes to smokefree bars, bar patronage, socially cued smoking, and perceived rights to smokefree workplaces. Results: The proportion of surveyed bars with smoking occurring decreased from 95% to 3% during July 2004 - April 2005. Between 2004 and 2005, public support for smokefree bars rose from 56% to 69%. In the same period, support for the rights of bar workers to have smokefree workplaces rose from 81% to 91%. During the first ten months of the smokefree bars policy, there were only 196 complaints to officials about smoking in the over 9900 licensed premises. The proportion of smokers who reported that they smoked more than normal at bars, nightclubs, casinos and cafes halved between 2004 and 2005 ( from 58% to 29%). Seasonally adjusted sales in bars and clubs changed little (0.6% increase) between the first three quarters of 2004 and of 2005, while cafe and restaurant sales increased by 9.3% in the same period. Both changes continued existing trends. Compared to the same period in 2004, average employment during the first three quarters of 2005 was up 24% for 'pubs, taverns and bars', up 9% for cafes/restaurants, and down 8% for clubs ( though employment in 'pubs, taverns and bars' may have been affected by unusually high patronage around a major sports-series). The proportion of bar managers who approved of smokefree bars increased from 44% to 60% between November 2004 and May 2005. Bar managers also reported increased agreement with the rights of bar workers and patrons to smokefree environments. The main reported concerns of the national and regional Hospitality Associations, in 2005, were the perceived negative effects on rural and traditional pubs. Conclusion: As in other jurisdictions, the introduction of smokefree bars in New Zealand has had positive overall health protection, economic and social effects; in contrast to the predictions of opponents.

Torronen J; Maunu A. Going out, sociability, and cultural distinctions. Nordic Studies on Alcohol and Drugs 22(English Supplement): 25-44, 2005. (38 refs.)

Aim: Pubs are focal stages of sociability. This article investigates the identifications and distinctions between 'us' and 'them', made by young Finns talking about their own behaviour in pubs, and the pubs they like and dislike. Data and Method: The data consists of 117 interviews with 23-35-year old young Finnish adults who work in business or administration The method applies classification analysis and is influence by the structuralist, semiotic and rhetoric traditions. Results: The analysis shows that many of the interviewees' classifications involve distancing themselves form those people that go to "superficial' pubs. The interviewees distinguish themselves from those frequenting superficial places by classifying the interactions there as false and stiff, and contrary to genuine and relaxed sociability. With these distinctions the interviewees do not aim to distinguish themselves as 'above' others. Instead, they define themselves as ordinary people by separating themselves form people who are fake, pretentious, or too faddish. Conclusions. This opposition to superficiality and the emphasis on authenticity is reminiscent of Rousseau's criticism of trivial needs. The interviewees seem to define sociability in pubs in a way that valorises the virtues of ordinariness and modesty.

Truong KD; Sturm R. Alcohol outlets and problem drinking among adults in California. Journal of Studies on Alcohol and Drugs 68(6): 923-933, 2007. (33 refs.)

Objective: The purpose of the study was to examine the relationship between alcohol environments and problem drinking, including excessive alcohol consumption, heavy episodic drinking, driving after drinking, and riding with a drinking driver. Method: We merged geo-coded individual -level data from the California Health Interview Survey and Los Angeles County Health Survey with alcohol license data from the California Department of Alcoholic Beverage Control, distinguishing off-sale retails from on-sale establishments and, among onsales, eating places from bars and taverns as well as minor-unrestricted establishments from minor-restricted establishments (i.e., youth below age 21 not allowed on business premises). The primary explanatory variable was alcohol outlets within various distances from an individual's residence or census tract. Multivariate logistic regression and simulation were run for men and women separately. Results: On-sale establishments, particularly minor-restricted establishments, were significantly associated with excessive alcohol consumption and heavy episodic drinking, after controlling for individual and neighborhood sociodemographics. The effect was limited to outlets located within proximity, roughly I mile from residential homes. Off-sale retails were not found to be related to problem drinking. If the number of minor-restricted establishments increases from median to 90th percentile of their distribution, heavy episodic drinking would increase from 11.1% to 14.3% among women and from 19.6% to 22.0% among men. Conclusions: Certain types of alcohol retailers in neighborhoods were associated with problem drinking. Moratorium of new licenses based on number of licenses per capita at county level is not effective because only a subgroup of licenses matters, and alcohol is more available in terms of distance, travel time, or search costs in densely populated cities.

Umesao T. Alcoholic beverages and civilization. Keynote address. IN: Umesao T; Yoshida S; Schalow P, eds. Japanese Civilization in the Modern World. XVIII, Alcoholic Beverages. Senri Ethnological Studies no. 64. Osaka Japan: National Museum of Ethnology (Japan), 2003. pp. 1-16. (12 refs.)

This chapter provides an overview of the topic of alcohol consumption, by briefly reviewing the use of alcohol from the earliest records globally and the production of different types of beverages. In Japan, while sake had been used ritually for the preceding 500 years, it was first produced commercially, and taxed in the 15th century. The ultimate growth of this industry was tied to technology, but not the technology of distillation, but the nature of the containers used for both production and trans