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CORK Bibliography: Bars and Alcohol Sale Outlets

73 citations. January 2010 to present

Prepared: March 2012

Abdon JG; Wallin E; Andreasson S. The "Clubs against Drugs" program in Stockholm, Sweden: Two cross-sectional surveys examining drug use among staff at licensed premises. Substance Abuse, Treatment, Prevention and Policy 6: article 2, 2011. (38 refs.)

Background: The objective of this study is to examine self-reported drug use among staff at licensed premises, types of drugs used, attitudes towards drugs, and observed drug use among guests. Results are presented from two measurement points (in 2001 and 2007/08). This study was carried out within the framework of the "Clubs against Drugs" program, which is a community-based multi-component intervention targeting licensed premises in Stockholm, Sweden. Methods: Two cross-sectional surveys were conducted, the first in 2001 and the second in 2007/08. Staff at licensed premises attending server training were asked to participate in the anonymous survey. A survey was administered in a classroom setting and consisted of four sections: 1) demographics, 2) respondents' own drug use experience, 3) respondents' attitudes towards drug use, and 4) observed drug use among guests at licensed premises. Results: Data were collected from 446 staff in 2001 and 677 staff in 2007/08. The four most commonly used drugs among staff were cannabis, cocaine, amphetamine, and ecstasy. The highest rates of drug use were reported by staff in the two youngest age groups, i.e., those younger than 25 and those between the ages of 25 and 29. In 2007/08 staff reported significantly lower rates of drug use than staff in 2001. Last year drug use for the sample in 2007/08 was 19% compared to 27% for the 2001 sample. While drug-using staff compared to non drug-using staff reported more observations of drug use among guests, they were less inclined to intervene. Overall, staff reported restrictive attitudes towards drugs. Conclusions: The prevalence of life-time and last year drug use among staff at licensed premises is high compared to the general population in Sweden. Lower rates of self-reported drug use among staff were reported in 2007/08. The results of this study highlight that staff at licensed premises represent an important target population in club drug prevention programs.

Copyright 2011, BioMedical Central

Abdon JG; Wallin E; Andreasson S. Long-term effects of a community-based intervention: 5-year follow-up of 'Clubs against Drugs'. Addiction 106(11): 1997-2004, 2011. (39 refs.)

Aims To evaluate long-term effects of a multi-component community-based club drug prevention programme. Design: A pre- (2003) and post-intervention study (2004 and 2008) design. Setting: High-risk licensed premises in central Stockholm, Sweden. Participants: The intervention programme, 'Clubs against Drugs', included community mobilization, drug-training for doormen and other staff, policy work, increased enforcement, environmental changes and media advocacy and public relations work. Measurement: The indicator chosen for this study was the frequency of doormen intervention towards obviously drug-intoxicated guests at licensed premises. Professional male actors (i.e. pseudopatrons) were trained to act impaired by cocaine/amphetamines while trying to enter licensed premises with doormen. An expert panel standardized the scene of drug intoxication. Each attempt was monitored by two male observers. Findings: At the follow-up study in 2008 the doormen intervened in 65.5% of the attempts (n = 55), a significant improvement compared to 27.0% (n = 48) at the first follow-up in 2004 and to 7.5% (n = 40) at baseline in 2003. Conclusion: The 'Clubs against Drugs' community-based intervention programme, a systems approach to prevention, appears to increase the frequency and effectiveness of club doormen's interventions regarding obviously drug-intoxicated guests.

Copyright 2011, Society for the Study of Addiction

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

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

Copyright 2009, Sage Publications

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

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

Copyright 2010, Springer

Ao TTH; Sam N; Kiwelu I; Mahal A; Subramanian SV; Wyshak G et al. Risk factors of alcohol problem drinking among female bar/hotel workers in Moshi, Tanzania: A Multi-level analysis. AIDS and Behavior 15(2): 330-339, 2011. (43 refs.)

There is limited information on alcohol problem drinking, which has been associated with sexually transmitted infections (STIs), including HIV, among female bar/hotel workers in Africa. This paper aimed to identify the individual- and facility-level determinants of alcohol problem drinking in this setting. Problem drinking was defined based on the CAGE alcohol screening scale. Multi-level logistic regression was used to identify individual- and facility-level factors associated with problem drinking. About 37.3% of women (N = 1629) were classified as having probable or definite problem drinking. In multi-level analysis, main characteristics associated with problem drinking included: having 3-4 partners in the past 5 years compared to having 1-2, used a condom in the last sex comparing to non-use, history of transactional sex, having more pregnancies, and facilities whose employees do not live on the premises. Interventions which combine alcohol and sexual risk reduction counseling are urgently needed in this population.

Copyright 2011, Springer

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

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

Copyright 2011, Elsevier Science

Beck KH; Ahmed A; Farkas ZA. A descriptive analysis of the social context of drinking among first-time DUI offenders. Traffic Injury Prevention 12(4): 306-311, 2011. (39 refs.)

Objective: To understand the role of social context in contributing to the incidence of alcohol-impaired driving. Methods: Telephone interviews were conducted with 161 individuals who received a first-time DUI citation. They were predominantly white (70%), male (62%) and 21 to 45 years of age (62%). They were paid $25 for their participation. Questions were asked about their social network, the social context in which they typically drink, the specific location and circumstances where they were drinking at the time of their citation, risky driving behaviors, in the last month as well as the number of traffic tickets they received and crashes they have been involved in since they started to drive. Results: Two reliable social contexts of drinking were identified through principle components factors analysis: emotional pain and social facilitation. Analyses of variance showed that drinking in a context of emotional pain (eg, to deal with depression, stress) was related to drinking alone at this location and driving when they know they have had too much to drink. Drinking in a context of social facilitation (eg, with friends, to be sociable) was related to drinking more frequently and with others (versus alone) at this location. Social facilitation was also positively related to driving over the speed limit and running a red light/stop sign. Conclusions: The social context of drinking is important for understanding the social network of drinking drivers, because most (86%) said that someone from their social network was with them at this drinking location. The need to understand how significant others influence the context of drinking as well as the likelihood of impaired driving is critical for program development. These results suggest that different types of interventions are needed for offenders depending on their social context of drinking.

Copyright 2011, Taylor & Francis

Bedford O; Hwang SL. Flower drinking and masculinity in Taiwan. Journal of Sex Research 48(1): 82-92, 2011. (32 refs.)

This study explores the role of the hostess club culture in the creation and maintenance of masculinity in Taiwan. The article focuses on flower drinking (the consumption of alcohol in bars, often integrated with prostitution), which is a common practice in Taiwan. Data were obtained from 58 in-depth interviews with men from a variety of occupations and social backgrounds (mean age = 38.50, SD = 11.00) and 73 questionnaires administered to soldiers (mean age = 21.00, SD = 1.10). Findings indicated that demonstration of skill at flower drinking and facility with the related social etiquette are important channels for male bonding that were central to the mid-to upper-class participants' professional development. Flower drinking also provided a method of discriminating men from other men through their choices of why and where to go and how to behave while there. Specific ways that Taiwanese masculinity differs from Western and from Japanese masculinity, and support for the continuing relevance of the traditional Confucian ideal of masculinity, wen-wu, are discussed.

Copyright 2011, Taylor & Francis

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

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

Copyright 2010, Biomedical Central

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

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

Copyright 2010, John Wiley & Sons

Bolier L; Voorham L; Monshouwer K; van Hasselt N; Bellis M. Alcohol and drug prevention in nightlife settings: A review of experimental studies. (review). Substance Use & Misuse 46(13): 1569-1591, 2011. (69 refs.)

This study examines the evidence regarding the effectiveness of interventions aimed at the prevention of harmful alcohol and drug use in nightlife settings. A literature search was conducted in 2009. Of 161 studies, 17 experimental studies were included in the review, 15 alcohol-related and two drug-related studies. The results show that preventive substance abuse interventions in nightlife settings can effectively reduce high-risk alcohol consumption, alcohol-related injury, violent crimes, access to alcohol by underage youth, and alcohol service to intoxicated people. A combination of approaches such as enforcement activities seem to be facilitating factors. However, results should be considered cautiously as more gold standard (cost-) effectiveness research is required, in particular directed at drug prevention and educational interventions in nightlife settings.

Copyright 2011, Informa Healthcare

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

Branas CC; Richmond TS; Ten Have TR; Wiebe DJ. Acute alcohol consumption, alcohol outlets, and gun suicide. Substance Use & Misuse 46(13): 1592-1603, 2011. (80 refs.)

A case-control study of 149 intentionally self-inflicted gun injury cases (including completed gun suicides) and 302 population-based controls was conducted from 2003 to 2006 in a major US city. Two focal independent variables, acute alcohol consumption and alcohol outlet availability, were measured. Conditional logistic regression was adjusted for confounding variables. Gun suicide risk to individuals in areas of high alcohol outlet availability was less than the gun suicide risk they incurred from acute alcohol consumption, especially to excess. This corroborates prior work but also uncovers new information about the relationships between acute alcohol consumption, alcohol outlets, and gun suicide. Study limitations and implications are discussed.

Copyright 2011, Informa Healthcare

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

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

Copyright 2010, BMJ Publishing

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

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

Copyright 2010, Oxford University Press

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

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

Copyright 2010, Alcohol Research Documentation

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

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

Copyright 2010, Wiley-Blackwell

Connor JL; Kypri K; Bell ML; Cousins K. Alcohol outlet density, levels of drinking and alcohol-related harm in New Zealand: A national study. Journal of Epidemiology and Community Health 65(10): 841-846, 2011. (44 refs.)

Background: Previous research shows associations of geographical density of alcohol outlets with a range of alcohol-related harms. Socioeconomic conditions that are associated with both outlet density and alcohol-related outcomes may confound many studies. We examined the association of outlet density with both consumption and harm throughout New Zealand while controlling for indicators of area deprivation and individual socioeconomic status (SES). Methods: Individual alcohol consumption and drinking consequences were measured in a 2007 national survey of 18-70 year olds (n=1925). All alcohol outlets in New Zealand were geocoded. Outlet density was the number of outlets of each type (off-licences (stores that sell alcoholic beverages for consumption elsewhere), bars, clubs, restaurants) within 1 km of a person's home. We modelled the association of outlet density with total consumption, binge drinking, risky drinking (above New Zealand guidelines) and two measures of effects ('harms' and 'troubles' due to drinking) in the previous year. Logistic regression and zero-inflated Poisson models were used, adjusting for sex, educational level, a deprivation index (NZDep06) and a rurality index. Results: No statistically significant association was seen between outlet density and either average alcohol consumption or risky drinking. Density of off-licences was positively associated with binge drinking, and density of all types of outlet was associated with alcohol-related harm scores, before and after adjustment for SES. Associations of off-licences and clubs with trouble scores were no longer statistically significant in the adjusted analysis. Conclusions: The positive associations seen between alcohol outlet density and both individual level binge drinking and alcohol-related problems appear to be independent of individual and neighbourhood SES. Reducing density of alcohol outlets may reduce alcohol-related harm among those who live nearby.

Copyright 2011, BMJ Publishing Group

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

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

Copyright 2010, Public Health Association of Australia

Corral JE; Cornejo JA; Barnoya J. Bars' and restaurants' compliance with the Guatemalan smoke-free law during the 2010 Soccer World Cup: A missed opportunity. Tobacco Control 20(6): 445-446, 2011. (9 refs.)

On February 2009, the Guatemalan Congress passed a nationwide law that banned smoking in all workplaces, including bars and restaurants. The Ministry of Health (MoH) is responsible for monitoring law compliance and fining violators. Individuals and venues are subject to economic fines when they break the law. The Soccer World Cup is the biggest sporting event worldwide (more than 700 hundred million people watched the televised final match).5 In Guatemala, thousands of soccer fans rush to bars and restaurants to watch the games. Employee absenteeism rate is reported to be 20% and sales in bars and restaurants expected to increase up to 300% during the tournament.6-8 Therefore, this was a great opportunity for the MoH to strengthen law enforcement and collect fines. This study sought to monitor law compliance in bars and restaurants during the 2010 Soccer World Cup. Between two and five research assistants watched each game for customers smoking inside, inappropriate 'No-Smoking' signage and availability of a smoking section. Overall, 114 observations were made during 29 matches (12 venues were visited twice). The mean number of customers per game was 21.4 (SD 3.99) in bars and 56.2 (SD 8.35) in restaurants. The most frequent violation was allowing smoking inside the venue ( while inappropriate 'No Smoking' signage in the venue would have yielded the highest total fine revenue. If appropriately enforced, the MoH could have collected US$88?259 in fines. Funds collected over this 1-month period would have been enough to hire 16 MoH staff to effectively monitor, track and fine the offending businesses for 1 year.

Copyright 2011, BMJ Publishing

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

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

Copyright 2010, BMJ Publishing

Fabian LEA; Bernat DH; Lenk KM; Shi Q; Forster JL. Smoke-free laws in bars and restaurants: Does support among teens and young adults change after a statewide smoke-free law? Public Health Reports 126(5): 669-676, 2011. (25 refs.)

Objective. We assessed changes in levels of support for smoke-free bars and restaurants among teens and young adults before and after implementation of a statewide smoke-free law. Methods. We measured support for smoke-free bars and restaurants among teens and young adults aged 16-24 years living in Minnesota (n=2,785) and five comparison states (n=404), up to 12 months before and up to six months after Minnesota's smoke-free law went into effect in October 2007. We compared changes in support among three subgroups Minnesota participants who lived with a previous local smoke-free law, Minnesota participants who did not live with a previous local smoke-free law, and participants from the comparison states before and after Minnesota's statewide smoke-free law went into effect. Results. Support for smoke-free restaurants and bars among participants in Minnesota and comparison states increased after Minnesota's smoke-free law went into effect. Minnesotans, both those living with and without a previous local smoke-free law, showed similar increases in support for smoke-free restaurants as participants in comparison states. However, Minnesotans living without a previous local law showed larger increases in support for smoke-free bars than both those in comparison states and those living in Minnesota with a previous local smoke-free law. Conclusions. Our study employed a more robust design than similar studies and focused on the teen and young adult population. Our results will help advocates and policy makers demonstrate how public support for smoke-free laws increases following smoke-free legislation, particularly among those who were not previously living with a local smoke-free law.

Copyright 2011, Association of Schools of Public Health

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

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

Copyright 2010, Lippincott, Williams & Wilkins

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

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

Copyright 2010, Informa Healthcare

Fritz K; McFarland W; Wyrod R; Chasakara C; Makumbe K; Chirowodza A et al. Evaluation of a peer network-based sexual risk reduction intervention for men in beer halls in Zimbabwe: Results from a randomized controlled trial. AIDS and Behavior 15(8): 1732-1744, 2011. (49 refs.)

While much emphasis has been placed on involving men in AIDS prevention in sub-Saharan Africa, there remain few rigorously evaluated interventions in this area. A particularly appealing point of intervention is the sexual risk behavior associated with men's alcohol consumption. This article reports the outcomes of The Sahwira HIV Prevention Program, a male-focused, peer-based intervention promoting the idea that men can assist their friends in avoiding high-risk sexual encounters associated with alcohol drinking. The intervention was evaluated in a randomized, controlled trial (RCT) implemented in 24 beer halls in Harare, Zimbabwe. A cadre of 413 male beer hall patrons (similar to 20% of the patronage) was trained to assist their male peers within their friendship networks. Activities included one-on-one interactions, small group discussions, and educational events centering on the theme of men helping their male friends avoid risk. Venues were randomized into 12 control versus 12 intervention beer halls with little cross-contamination between study arms. The penetration and impact of the intervention were assessed by pre- and post-intervention cross-sectional surveys of the beer hall patronage. The intervention was implemented with a high degree of fidelity to the protocol, with exposure to the intervention activities significantly higher among intervention patrons compared to control. While we found generally declining levels of risk behavior in both study arms from baseline to post-intervention, we found no evidence of an impact of the intervention on our primary outcome measure: episodes of unprotected sex with non-wife partners in the preceding 6 months (median 5.4 episodes for men at intervention beer halls vs. 5.1 among controls, P = 0.98). There was also no evidence that the intervention reduced other risks for HIV. It remains an imperative to find ways to productively engage men in AIDS prevention, especially in those venues where male bonding, alcohol consumption, and sexual risk behavior are intertwined.

Copyright 2011, Springer Publishing

Gallimberti L; Chindamo S; Buja A; Forza G; Tognazzo F; Galasso L et al. Underage drinking on Saturday nights, sociodemographic and environmental risk factors: A cross-sectional study. Substance Abuse Treatment, Prevention and Policy 6: e-article 15, 2011. (27 refs.)

Background: Excessive alcohol consumption in underage people is a rising phenomenon. A major proportion of the disease burden and deaths of young people in developed nations is attributable to alcohol abuse. The aim of this study was to investigate social, demographic and environmental factors that may raise the risk of Saturday night drinking and binge drinking among Italian school students. Methods: The study was conducted on a sample of 845 Italian underage school students, by means of an anonymous, self-test questionnaire. Multivariate logistic regression was applied to identify independent risk factors for alcohol drinking and binge drinking. Ordered logistic regression was used to identify independent risk factors for harmful drinking patterns. Results: The independent variables that confer a higher risk of drinking in underage students are older age classes, male sex, returning home after midnight, belonging to a group with little respect for the rules, or to a group where young people are not seen as leaders. The higher the perception of alcohol consumption by the group, the higher the risk. Spending time in bars or discos coincides with a two-fold or four-fold increase, respectively, in the risk of alcohol consumption. Conclusion: Our findings show that certain environmental and social risk factors are associated with underage drinking. The most important role for preventing young people's exposure to these factors lies with the family, because only parents can exert the necessary control and provide a barrier against potentially harmful situations.

Copyright 2011, BioMed Central

Graham K; Bernards S; Wells S; Osgood DW; Abbey A; Felson RB et al. Behavioural indicators of motives for barroom aggression: Implications for preventing bar violence. Drug and Alcohol Review 30(5, special issue): 554-563, 2011. (45 refs.)

Introduction and Aims. To develop new strategies for preventing violence in high-risk licensed premises, we identify behavioural indicators of apparent motives for aggression in these settings and outline the implications of different motivations for prevention. Design and Methods. The four types of motives for aggressive or coercive acts defined by the theory of coercive actions framed the research: gaining compliance, expressing grievances/restoring justice, attaining a favourable social identity and pursuing fun/excitement. Incidents of aggression from the Safer Bars evaluation research were analysed to identify behavioural indicators of each motivation. Results. Compliance-motivated aggression typically takes the form of unwanted social overtures, third party intervention to stop conflicts or staff rule enforcement. Prevention strategies include keeping the aggressor's focus on compliance to avoid provoking grievance and identity motives that are likely to escalate aggression. Grievance motives are typically elicited by perceived wrongdoing and therefore prevention should focus on eliminating sources of grievances and adopting policies/practices to resolve grievances peacefully. Social identity motives are endemic to many drinking establishments especially among male patrons and staff. Prevention involves reducing identity cues in the environment, hiring staff who do not have identity concerns, and training staff to avoid provoking identity concerns. Aggression motivated by fun/excitement often involves low-level aggression where escalation can be prevented by avoiding grievances and attacks on identity. Discussion and Conclusions. Knowledge of behavioural indicators of motives can be used to enhance staff hiring and training practices, reduce environmental triggers for aggression, and develop policies to reduce motivation for aggression.

Copyright 2011, Wiley-Blackwell

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

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

Copyright 2010, Taylor & Francis

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

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

Copyright 2010, Alcohol Research Documentation

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

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

Copyright 2010, Elsevier Science

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

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

Copyright 2010, Elsevier Science

Issa JS; Abe TMO; Pereira AC; Megid MC; Shimabukuro CE; Valentin LSO et al. The effect of Sao Paulo's smoke-free legislation on carbon monoxide concentration in hospitality venues and their workers. Tobacco Control 20(2): 156-162, 2011. (21 refs.)

Background Studies have shown that there is no safe level of secondhand smoke (SHS) exposure and there is a close link between SHS and the risk of coronary heart disease and stroke. Carbon monoxide (CO) is one of the most important components present in SHS. Objective To evaluate the impact of the smoking ban law in the city of Sao Paulo, Brazil, on the CO concentration in restaurants, bars, night clubs and similar venues and in their workers. Methods In the present study we measured CO concentration in 585 hospitality venues. CO concentration was measured in different environments (indoor, semi-open and open areas) from visited venues, as well as, in the exhaled air from approximately 627 workers of such venues. Measurements were performed twice, before and 12 weeks after the law implementation. In addition, the quality of the air in the city during the same period of our study was verified. Results The CO concentration pre-ban and pot-ban in hospitality venues was indoor area 4.57 (3.70) ppm vs 1.35 (1.66) ppm (p<0.0001); semi-open 3.79 (2.49) ppm vs 1.16 (1.14) ppm (p<0.0001); open area 3.31 (2.2) ppm vs 1.31 (1.39) ppm (p<0.0001); smoking employees 15.78 (9.76) ppm vs 11.50 (7.53) ppm (p<0.0001) and non-smoking employees 6.88 (5.32) ppm vs 3.50 (2.21) ppm (p<0.0001). The average CO concentration measured in the city was lower than 1 ppm during both pre-ban and post-ban periods. Conclusion Sao Paulos smoking-free legislation reduced significantly the CO concentration in hospitality venues and in their workers, whether they smoke or not.

Copyright 2011, BMJ Publishing Group

Jackson CK; Owens EG. One for the road: Public transportation, alcohol consumption, and intoxicated driving. Journal of Public Economics 95(1-2): 106-121, 2011. (38 refs.)

We exploit arguably exogenous train schedule changes in Washington DC to investigate the relationship between public transportation, the risky decision to consume alcohol, and the criminal decision to engage in alcohol-impaired driving. Using variation over time, across days of the week, and over the course of the day, we provide evidence that overall there was little effect of expanded public transit service on DUI arrests, alcohol related fatal traffic and alcohol related arrests. However, we find that these overall effects mask considerable heterogeneity across geographic areas. Specifically, we find that areas where bars are within walking distance to transit stations experience increases in alcohol related arrests and decreases in DUI arrests. We observe no sign of behavioral changes in neighborhoods without any bars within walking distance of transit stations.

Copyright 2011, Elsevier Science

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

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

Copyright 2010, American Association of Cancer Research

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

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

Copyright 2010, Oxford University Press

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

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

Copyright 2010, National Institute on Alcohol Abuse and Alcoholism

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

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

Copyright 2011, MDPI AG

Kurtz SP; Surratt HL; Levi-Minzi MA; Mooss A. Benzodiazepine dependence among multidrug users in the club scene. Drug and Alcohol Dependence 119(1-2): 99-105, 2011. (45 refs.)

Background: Benzodiazepines (BZs) are among the most frequently prescribed drugs with the potential for abuse. Young adults ages 18-29 report the highest rates of BZ misuse in he United States. The majority of club drug users are also in this age group, and BZ misuse is prevalent in the nightclub scene. BZ dependence, however, is not well documented. This paper examines BZ dependence and its correlates among multidrug users in South Florida's nightclub scene. Methods: Data were drawn from structured interviews with men and women (N=521) who reported regular attendance at large dance clubs and recent use of both club drugs and BZs. Results: Prevalences of BZ-related problems were 7.9% for BZ dependence, 22.6% BZ abuse, and 25% BZ abuse and/or dependence. In bivariate logistic regression models, heavy cocaine use (OR 2.27; 95% CI 1.18, 4.38), severe mental distress (OR 2.63; 95% CI 1.33, 5.21), and childhood victimization history (OR 2.43; 95% CI 1.10, 5.38) were associated with BZ dependence. Heavy cocaine use (OR 2.14; 95% CI 1.10, 4.18) and severe mental distress (OR 2.16; 95% CI 1.07, 4.37) survived as predictors in the multivariate model. Discussion: BZ misuse is widespread among multidrug users in the club scene, who also exhibit high levels of other health and social problems. BZ dependence appears to be more prevalent in this sample than in other populations described in the literature. Recommendations for intervention and additional research are described.

Copyright 2011, Elsevier Science

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

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

Copyright 2011, Society for the Study of Addiction to Alcohol and Other Drugs

Leibel K; Lee JGL; Goldstein AO; Ranney LM. Barring intervention? Lesbian and gay bars as an underutilized venue for tobacco interventions. (editorial). Nicotine & Tobacco Research 13(7): 507-511, 2011. (33 refs.)

Lesbian, gay, bisexual, and transgender (LGBT) communities are at high risk for tobacco use. While LGBT communities have historically considered bars to be safe places to socialize and congregate, these spaces are often tobacco-friendly environments and may have potential as sites for much needed intervention. Only a few public health interventions have attempted to work through bars and clubs to decrease tobacco use in the LGBT populations. Evidence from HIV prevention suggests some potential interventions in bars, and the tobacco industry has worked extensively (and successfully) to utilize bars in marketing efforts. Lesbian and gay bars are underutilized in tobacco control, suggesting missed avenues for chronic disease prevention programs. Researchers and communities should continue to recognize the importance of clean indoor air laws covering bars and develop additional strategies for reaching LGBT populations with disparities.

Copyright 2011, Oxford University Press

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

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

Copyright 2010, BMJ Publishing

Liang WB; Chikritzhs T. Revealing the link between licensed outlets and violence: Counting venues versus measuring alcohol availability. Drug and Alcohol Review 30(5, special issue): 524-535, 2011. (30 refs.)

Introduction and Aims. Associations between alcohol-related harms and numbers of outlets at the neighbourhood level have been demonstrated; however, the degree to which alcohol consumption or sales plays a part in levels of violence is not clear. This has contributed to uncertainty regarding the actual mechanisms by which outlet density may influence levels of violence. This ecological cross-sectional study investigated the effect of outlet numbers and alcohol sales on the risk of assault in Western Australia. Design and Methods. For 2000/2001, information on type, number and wholesale alcohol purchases of all licensed outlets in operation, police-reported assault offences, socioeconomic/demographic data were obtained from official sources. Multivariate negative binomial regression was applied to at local government area level in order to assess associations between outlet density, alcohol sales and violence occurring in both licensed and domestic settings. Results. Average alcohol sales volume per off-site outlet was significantly associated with all measures of assault. Numbers of on-site outlets significantly predicted violence with the exception of assaults occurring at residential premises. Alcohol sales from off-site outlets predicted violence occurring at on-site outlets. Discussion and Conclusions. The link between on-site outlets and violence may be primarily underpinned by negative amenity effects while off-site outlet effects occur via increased availability. Alcohol sales volumes from off-site outlets influence levels of violence, which occur at both licensed and residential settings. The substantial and wide-ranging effects of liquor stores on alcohol-related harms may have been underestimated in the literature and by policy makers.

Copyright 2011, Wiley-Blackwell

Liu RL; Yang Y; Travers MJ; Fong GT; O'Connor RJ; Hyland A et al. A cross-sectional study on levels of secondhand smoke in restaurants and bars in five cities in China. Tobacco Control 20(6): 397-402, 2011. (20 refs.)

Objectives: To assess indoor secondhand smoke (SHS) exposure in restaurants and bars via PM(2.5) level measurements in five cities in China. Methods The study was conducted from July to September in 2007 in Beijing, Xi'an, Wuhan, Kunming and Guiyang. PM(2.5) concentrations were measured in 404 restaurants and bars using portable aerosol monitors. The occupant density and the active smoker density were calculated for each venue sampled. Results: Among the 404 surveyed venues, 23 had complete smoking bans, nine had partial smoking bans and 313 (77.5%) had smoking observed during sampling. The geometric mean of indoor PM(2.5) levels in venues with smoking observed was 208 mug/m(3) and 99 mug/m(3) in venues without smoking observed. When outdoor PM(2.5) levels were adjusted, indoor PM(2.5) levels in venues with smoking observed were consistently significantly higher than those in venues without smoking observed (F=80.49, p<0.001). Indoor PM(2.5) levels were positively correlated with outdoor PM(2.5) levels (partial rho=0.37 p<0.001) and active smoker density (partial rho=0.34, p<0.001). Conclusions: Consistent with findings in other countries, PM(2.5) levels in smoking places are significantly higher than those in smoke-free places and are strongly related to the number and density of active smokers. These findings document the high levels of SHS in hospitality venues in China and point to the urgent need for comprehensive smoke-free laws in China to protect the public from SHS hazards, as called for in Article 8 of the Framework Convention on Tobacco Control, which was ratified by China in 2005.

Copyright 2011, BMJ Publishing Group

Livingston M. Alcohol outlet density and harm: Comparing the impacts on violence and chronic harms. Drug and Alcohol Review 30(5, special issue): 515-523, 2011. (60 refs.)

Introduction and Aims. A number of studies have previously identified relationships between the density of alcohol outlets and rates of violence, with different types of outlets related to violence in different locations. The previous work in Australia has been limited to studies based on police data, which are subject to numerous biases. This study extends the previous work by utilising hospital admissions as a less biased outcome measure, incorporating a 14 year longitudinal design and by developing comparative models for violence and rates of alcohol use disorders. Design and Methods. The study examines trends in postcode-level hospital admission data for assault and for alcohol use disorders over a 14 year period (n = 186) and their relationship with the density of three kinds of alcohol outlets. Fixed-effects models are developed to control for the differences between postcodes and for the overall trends in outlet density and morbidity rates. Results. The results of this study suggest that the density of alcohol outlets where the main activity is alcohol consumption (i.e. pubs) is positively related to rates of assault-related hospital admissions, while the density of off-premise alcohol outlets is related to the rate of alcohol use disorders. Discussion and Conclusions. These findings have significant implications for alcohol policies in Victoria, in particular pointing to the significant contribution of packaged alcohol outlets to both acute and chronic alcohol-related harm.

Copyright 2011, Wiley-Blackwell

Lopez MJ; Burhoo P; Moussa L; Nebot M. Secondhand smoke assessment in the first African country adopting a comprehensive smoke-free law (Mauritius). Environmental Research 111(8): 1024-1026, 2011. (15 refs.)

A new smoking regulation came into force in Mauritius in March 2009. Environmental nicotine and particles less than 2.5 mu m in diameter (PM2.5) were measured in 60 hospitality venues and shopping malls on December 2009. There was presence of secondhand smoke in 69% of the samples. The overall median [IQR] nicotine and PM2.5 concentrations were 0.05 [ < L.Q.-0.17] and 20.28 mu g/m(3) [IQR: 13.00-59.80], respectively. The highest concentrations of both markers were found in night clubs.

Copyright 2011, Elsevier Science

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

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

Copyright 2010, University of Puerto Rico Medical Sciences Campus

Measham F; Wood, DM; Dargan PI; Moore K. The rise in legal highs: Prevalence and patterns in the use of illegal drugs and first- and second-generation "legal highs" in South London gay dance clubs. Journal of Substance Use 16(4): 263-272, 2011. (35 refs.)

Aim: To assess the prevalence of use of established illegal psychoactive drugs and emergent psychoactive drugs, the so-called "legal highs", amongst gay club-goers who are considered to be "early adopters" of drug trends. Design: Three in situ surveys were conducted in July 2010 with customers at two dance clubs (nightclubs) in an area known for its "gay-friendly" night time economy. The surveys assessed the prevalence of self-reported lifetime, past year, past month, fieldwork day use and planned use of illegal drugs and "legal highs". Setting: This is a field study. Participants: The participants were 308 customers in two "gay-friendly" clubs in South London, United Kingdom. Measurements: Two-page research instrument was designed for in situ drug surveys. Findings: Our sample had higher rates of self-reported lifetime and recent use of established illegal drugs than the general population. Mephedrone emerged from near obscurity to become the most popular illegal drug in this survey, with 41% having taken it in the past month and 27% having either taken and/or planning to take it on the fieldwork night. Regarding second-generation "legal highs", 11% of the sample had taken NRG-1 in the past month and 3% had taken and/or planned to take it on the fieldwork night. Conclusions: This survey suggests that the popularity of mephedrone surpasses other drugs, both legal and illegal, despite having been banned by the UK government prior to this survey being conducted. "Early adopters" of drug trends appear to be undeterred by the legal classification of emergent psychoactive substances. Given the global nature of the trade in "legal highs", this study has implications for other countries where mephedrone use is emerging.

Informa Healthcare

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

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

Copyright 2010, BioMed Central

Parks KA; Hsieh YP; Collins RL; Levonyan-Radloff K. Daily assessment of alcohol consumption and condom use with known and casual partners among young female bar drinkers. AIDS and Behavior 15(7): 1332-1341, 2011. (35 refs.)

The relationship between alcohol and condom use has been studied extensively over the past several decades. Reviews of event-level studies suggest that alcohol's effect on risky sexual behavior are not due to simple main effects, but appear to be dependent upon individual characteristics, and situational or contextual factors. In the current study, we assessed the temporal relationship between daily alcohol consumption and unprotected sexual behavior, taking into account sexual partner type (casual or known) as well as individual and situational characteristics among a group of young female bar drinkers. Greater alcohol consumption was not associated with unprotected sex. However, greater alcohol consumption was associated with an increase in sex (protected and unprotected) with casual partners. Having less HIV knowledge was associated with increased unprotected sex, while greater frequency of drinking in bars was associated with increased protected sex with casual partners. These findings are discussed in terms of possible prevention programs that increase HIV knowledge and decrease alcohol consumption to reduce young women's risky sexual behavior.

Copyright 2011, Springer

Reboussin BA; Song EY; Wolfson M. The impact of alcohol outlet density on the geographic clustering of underage drinking behaviors within census tracts. Alcoholism: Clinical and Experimental Research 35(8): 1541-1549, 2011. (52 refs.)

Background: The regulation of alcohol outlet density has been considered as a potential means of reducing alcohol consumption and related harms among underage youth. Whereas prior studies have examined whether alcohol outlet density was associated with an individual's alcohol consumption and related harms, this study examines whether it is related to the co-occurrence, or clustering, of these behaviors within geographic areas, specifically census tracts. Methods: The Enforcing Underage Drinking Laws Randomized Community Trial provided cross-sectional telephone survey data in 2006 and 2007 from 10,754 youth aged 14 to 20 from 5 states residing in 1,556 census tracts. The alternating logistic regression approach was used to estimate pairwise odds ratios between responses from youth residing in the same census tract and to model them as a function of alcohol outlet density. Results: Riding with a drinking driver, making an alcohol purchase attempt, and making a successful alcohol purchase attempt clustered significantly within census tracts with the highest off-premise alcohol outlet density while frequent drinking clustered within census tracts with the greatest on-premise density. Driving after drinking and experiencing nonviolent alcohol-related consequences clustered marginally within census tracts with the greatest on-premise and off-premise alcohol outlet density, respectively. Conclusions: Although youth primarily receive alcohol from social sources, commercial alcohol access is geographically concentrated within census tracts with the greatest off-premise outlet density. A potentially greater concern is the clustering of more frequent drinking and drinking and driving within census tracts with the greatest on-premise outlet density which may necessitate alternative census tract level initiatives to reduce these potentially harmful behaviors.

Copyright 2011, Wiley-Blackwell

Reed MB; Clapp JD; Weber M; Trim R; Lange J; Shillington AM. Predictors of partying prior to bar attendance and subsequent BrAC. Addictive Behaviors 36(12): 1341-1343, 2011. (13 refs.)

Pre-drinking (e.g., pre-gaming, pre-loading) occurs frequently among young adult and college-aged drinkers and is associated with increased intoxication as well as alcohol-related problems. The purpose of the following study was to examine pre-drinking behaviors in situ, and to test whether drinking intentions mediate the relationship between heavy episodic drinking history and pre-drinking behaviors. We randomly selected a sample of 1040 young adults bar patrons at 32 bars in a major metropolitan city in Southern California and asked participants to complete an interview concerning drinking behavior as well as provide a breath sample used to measure breath alcohol concentration. We used multilevel path analysis to test two meditational models. Results showed drinking intentions mediated the relationship between heavy episodic drinking history and pre-drinking behavior as well as the relationship between heavy episodic drinking history and level of pre-drinking intoxication. Gender did not moderate these meditational relationships suggesting similar pre-drinking behaviors for both men and women. Potential methods to prevent pre-drinking behaviors in this population of young people are discussed.

Copyright 2011, Elsevier Science

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

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

Copyright 2011, Heldref Publications

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

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

Copyright 2011, Oxford University Press

Rossheim ME; Thombs DL. Artificial sweeteners, caffeine, and alcohol intoxication in bar patrons. Alcoholism: Clinical and Experimental Research 35(10): 1891-1896, 2011. (23 refs.)

Background: Previous laboratory research on alcohol absorption has found that substitution of artificially sweetened alcohol mixers for sucrose-based mixers has a marked effect on the rate of gastric emptying, resulting in elevated blood alcohol concentrations. Studies conducted in natural drinking settings, such as bars, have indicated that caffeine ingestion while drinking is associated with higher levels of intoxication. To our knowledge, research has not examined the effects of alcohol mixers that contain both an artificial sweetener and caffeine, that is, diet cola. Therefore, we assessed the event-specific association between diet cola consumption and alcohol intoxication in bar patrons. We sought to determine whether putative increases in blood alcohol, produced by accelerated gastric emptying following diet cola consumption, as identified in the laboratory, also appear in a natural setting associated with impaired driving. Methods: We conducted a secondary analysis of data from 2 nighttime field studies that collected anonymous information from 413 randomly selected bar patrons in 2008 and 2010. Data sets were merged and recoded to distinguish between energy drink, regular cola, diet cola, and noncaffeinated alcohol mixers. Results: Caffeinated alcohol mixers were consumed by 33.9% of the patrons. Cola-caffeinated mixed drinks were much more popular than those mixed with energy drinks. A large majority of regular cola-caffeinated mixed drink consumers were men (75%), whereas diet cola-caffeinated mixed drink consumers were more likely to be women (57%). After adjusting for the number of drinks consumed and other potential confounders, number of diet cola mixed drinks had a significant association with patron intoxication (beta = 0.233, p < 0.0001). Number of drinks mixed with regular (sucrose-sweetened) cola and energy drinks did not have significant associations with intoxication (p > 0.05). Conclusions: Caffeine's effect on intoxication may be most pronounced when mixers are artificially sweetened, that is, lack sucrose which slows the rate of gastric emptying of alcohol. Risks associated with on-premise drinking may be reduced by greater attention given to types of mixers, particularly diet colas.

Copyright 2011, Wiley-Blackwell

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

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

Copyright 2010, Elsevier Science

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

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

Copyright 2010, BMJ Publishing Group

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

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

Copyright 2010, Oxford University Press

Shahrir S; Wipfli H; Avila-Tang E; Breysse PN; Samet JM; Navas-Acien A. Tobacco sales and promotion in bars, cafes and nightclubs from large cities around the world. Tobacco Control 20(4): 285-290, 2011. (22 refs.)

Context. Little is known about tobacco promotion activities in low and middle-income countries. Information on tobacco sales, advertisement and promotion in bars, cafes and nightclubs is needed to develop interventions to reduce smoking initiation and relapse, particularly among youths and young adults. Objective. To evaluate cigarette sales and tobacco advertisement and promotion in bars, cafes and nightclubs using a volunteer survey approach in large cities throughout the world. Methods. Between 2007 and 2009, we administered an interview-based survey to 231 bar/cafe/nightclub owners/managers in 24 large cities in Africa, the Americas, Asia and eastern Europe. Results. Cigarette sales and tobacco advertisement and promotions were found in bars/cafes/nightclubs in most cities. Examples of promotions included cigarette giveaways and event sponsorship. Establishments that allowed smoking were more likely to sell cigarettes compared to smoke-free establishments (OR 8.67, 95% CI 3.25 to 23.1). Larger establishments (maximum occupancy >= 100 vs <100 customers) were more likely to have tobacco advertising (OR 4.35, 95% CI 2.04 to 9.24) and to receive promotional items from tobacco companies (OR 3.18, 95% CI 1.41 to 7.17). Conclusions. Cigarette sales and tobacco promotions were common in bars, cafes and nightclubs in the majority of cities. Socialising and hospitality venues must be covered by legislation banning tobacco sales and promotions to limit exposure among populations at high risk of tobacco initiation and relapse from quitting.

Copyright 2011, BMJ Publishing Group

Sikkema KJ; Watt MH; Meade CS; Ranby KW; Kalichman SC; Skinner D et al. Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa. Journal of Acquired Immune Deficiency Syndromes 57(3): 230-237, 2011. (60 refs.)

Background: Alcohol-serving venues in South Africa provide a location for HIV prevention interventions due to risk factors of patrons in these establishments. Understanding the association between mental health and risk behaviors in these settings may inform interventions that address alcohol use and HIV prevention. Methods: Participants (n = 738) were surveyed in 6 alcohol-serving venues in Cape Town to assess post-traumatic stress disorder (PTSD) and depression symptoms, traumatic experiences, sexual behavior, and substance use. Logistic regression models examined whether traumatic experiences predicted PTSD and depression. Generalized linear models examined whether substance use, PTSD, and depressive symptoms predicted unprotected sexual intercourse. Men and women were analyzed separately. Results: Participants exhibited high rates of traumatic experiences, PTSD, depression, alcohol consumption, and HIV risk behaviors. For men, PTSD was associated with being hit by a sex partner, physical child abuse, sexual child abuse and HIV diagnosis; depression was associated with being hit by a sex partner, forced sex and physical child abuse. For women, both PTSD and depression were associated with being hit by a sex partner, forced sex, and physical child abuse. Unprotected sexual intercourse was associated with age, frequency and quantity of alcohol use, drug use, and PTSD for men and frequency and quantity of alcohol use, depression, and PTSD for women. Conclusion: Mental health in this setting was poor and was associated with sexual risk behavior. Treating mental health and substance-use problems may aid in reducing HIV infection. Sexual assault prevention and treatment after sexual assault may strengthen HIV prevention efforts.

Copyright 2011, Lippincott, Wilkins & Wilkins

St Helen G; Hall DB; Kudon LH; Pearce J; Baptiste S; Ferguson S et al. Particulate matter (PM(2.5)) and carbon monoxide from secondhand smoke outside bars and restaurants in downtown Athens, Georgia. Journal of Environmental Health 74(3): 9-17, 2011. (45 refs.)

In the study described in this article, the authors' objective was to measure particles <= 2.5 mu m in aerodynamic diameter (PM(2.5)) and carbon monoxide (CO) in outdoor waiting areas and patios of restaurants and bars in downtown Athens, Georgia, where indoor smoking is banned. The authors also wanted to investigate whether the measured concentrations are directly associated with the number of cigarettes lit in these settings. Real-time PM(2.5) and CO were monitored on four summer weekend afternoons/evenings in outdoor waiting areas or patios at five locations in Athens. In addition, smokers and pedestrians present or passing and motorized vehicles passing each sampling location were counted. PM(2.5) levels were significantly higher than levels at the control location (all p-values >.001). Carbon monoxide levels outside the restaurant and bar sites did not differ significantly from the control. The results of the authors' study indicate that (1) secondhand smoke (SHS) leads to significant increases in PM(2.5) outside of restaurants and bars; and (2) although CO can be used as a proxy for SHS in these outdoor environments, its levels remain relatively low.

Copyright 2011, National Environmental Health Association

Stanley LR; Henry KL; Swaim RC. Physical, social, and perceived availabilities of alcohol and last month alcohol use in rural and small urban communities. Journal of Youth and Adolescence 40(9): 1203-1214, 2011. (43 refs.)

This study seeks to provide a greater understanding of the factors that determine the perceived availability of alcohol and its role in predicting adolescents' alcohol use. Participants were 151,703 7th-12th grade students (50% female) from a sample of 219 rural communities across the United States, with oversampling for predominantly Mexican-American and African-American communities. Multilevel analysis was used to estimate the perceived availability of alcohol as a function of physical and social availability measures and individual and community-level control variables. Physical availability was measured as the number of alcohol outlets in the community and whether beer and wine were sold in non-liquor stores. Social availability measured the availability of alcohol from social or family groups. Last month alcohol use was then estimated as a function of physical, social and perceived availabilities and control variables. Physical availability had little relationship to perceived availability or recent alcohol use while social availability was a strong predictor of both. Perceived availabilities at the individual and community levels were significant in predicting last month alcohol use. The findings suggest that altering both perceived and actual availability of alcohol can potentially have strong effects on the levels of adolescent alcohol use.

Copyright 2011, Springer

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

Stockwell T; Zhao JH; Macdonald S; Vallance K; Gruenewald P; Ponicki W et al. Impact on alcohol-related mortality of a rapid rise in the density of private liquor outlets in British Columbia: A local area multi-level analysis. Addiction 106(4): 768-776, 2011. (32 refs.)

Aims: To study relationships between rates of alcohol-related deaths and (i) the density of liquor outlets and (ii) the proportion of liquor stores owned privately in British Columbia (BC) during a period of rapid increase in private stores. Design: Multi-level regression analyses assessed the relationship between population rates of private liquor stores and alcohol-related mortality after adjusting for potential confounding. Setting: The 89 local health areas of BC, Canada across a 6-year period from 2003 to 2008, for a longitudinal sample with n = 534. Measurements: Population rates of liquor store density, alcohol-related death and socio-economic variables obtained from government sources. Findings: The total number of liquor stores per 1000 residents was associated significantly and positively with population rates of alcohol-related death (P < 0.01). A conservative estimate is that rates of alcohol-related death increased by 3.25% for each 20% increase in private store density. The percentage of liquor stores in private ownership was also associated independently with local rates of alcohol-related death after controlling for overall liquor store density (P < 0.05). Alternative models confirmed significant relationships between changes in private store density and mortality over time. Conclusions: The rapidly rising densities of private liquor stores in British Columbia from 2003 to 2008 was associated with a significant local-area increase in rates of alcohol-related death.

Copyright 2011, Society for the Study of Addiction to Alcohol and Other Drugs

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

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

Copyright 2010, Informa Healthcare

Thombs D; Rossheim M; Barnett TE; Weiler RM; Moorhouse MD; Coleman BN. Is there a misplaced focus on AmED? Associations between caffeine mixers and bar patron intoxication. Drug and Alcohol Dependence 116(1-3): 31-36, 2011. (19 refs.)

Background: Previous research on alcohol mixed with energy drinks (AmED) suffers from measurement problems. Missing from the research literature are studies that assess caffeine-alcohol co-ingestion in natural drinking environments. Methods: This field study collected data in a U.S. college bar district from 328 randomly selected patrons. Anonymous data were obtained from face-to-face interviews and self-administered surveys, and from breath tests. Results: Cola-caffeinated alcoholic beverage consumers left bars in a more highly intoxicated state than those who consumed alcohol only. There was no significant difference between the intoxication level of the AmED group and the cola-caffeinated alcoholic beverage group. Results. from a multivariate regression model indicated that quantity of caffeinated alcoholic beverage consumption had a significant, positive association with bar patron intoxication after adjusting for potential confounders. Conclusions: Findings indicate that caffeine may have a dose-dependent relationship with alcohol intoxication in the bar/nightclub setting. In addition, results revealed that cola-caffeinated alcoholic drinks may pose similar levels of risk to bar patrons as those associated with AmED beverage consumption. Product labeling requirements about alcohol risks may need to be extended not only to energy drinks, but to caffeinated soft drinks as well.

Copyright 2011, Elsevier Science

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

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

Copyright 2009, Informa Healthcare

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

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

Copyright 2011, Wiley-Blackwell

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

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

Copyright 2010, Elsevier Science

van de Goor I; Spijkerman R; van den Eijnden R; Knibbe R. Drinking patterns and going-out behavior as predictors of illicit substance use: An analysis among Dutch adolescents. Journal of Child & Adolescent Substance Abuse 20(2): 99-113, 2011. (2 refs.)

This study examines relations between drinking patterns, going-out behavior, and illicit substance use among Dutch adolescents ages 15 to 24 who reported alcohol use at least once per week (N=711). Logistic regression analyses indicated that adolescents reporting heavy drinking patterns showed higher risks of lifetime and current illicit substance use. Weekday drinking increased the risk of lifetime substance use for the youngest (15-17 years) and those with lowest education levels. Going out to bars and dance parties also increased the risk of lifetime and current illicit drug use, suggesting that drink setting was related to youngsters' illicit substance use. In sum, these findings suggest that both drinking patterns and drink setting are important predictors of Dutch adolescents' illicit substance use.

Copyright 2011, Haworth Press

Van Havere T; Vanderplasschen W; Lammertyn J; Broekaert E; Bellis M. Drug use and nightlife: More than just dance music. Substance Abuse Treatment, Prevention and Policy 6: e-article 18, 2011. (58 refs.)

Background: Research over the last decade has focused almost exclusively on the association between electronic music and MDMA (3,4-Methylenedioxymethamphetamine or "ecstasy") or other stimulant drug use in clubs. Less attention has been given to other nightlife venues and music preferences, such as rock music or southern/funky music. This study aims to examine a broader spectrum of nightlife, beyond dance music. It looks at whether certain factors influence the frequency of illegal drug and alcohol use: the frequency of going to certain nightlife venues in the previous month (such as, pubs, clubs or goa parties); listening to rock music, dance music or southern and funky music; or sampling venues (such as, clubs, dance events or rock festivals). The question of how these nightlife variables influence the use of popular drugs like alcohol, MDMA, cannabis, cocaine and amphetamines is addressed. Methods: The study sample consisted of 775 visitors of dance events, clubs and rock festivals in Belgium. Study participants answered a survey on patterns of going out, music preferences and drug use. Odds ratios were used to determine whether the odds of being an illegal substance user are higher for certain nightlife-related variables. Furthermore, five separate ordinal regression analyses were used to investigate drug use in relation to music preference, venues visited during the last month and sampling venue. Results: Respondents who used illegal drugs were 2.5 times more likely to report that they prefer dance music. Goa party visitors were nearly 5 times more likely to use illegal drugs. For those who reported visiting clubs, the odds of using illegal drugs were nearly 2 times higher. Having gone to a pub in the last month was associated with both more frequent alcohol use and more frequent illegal substance use. People who reported liking rock music and attendees of rock festivals used drugs less frequently. Conclusions: It was concluded that a more extended recreational environment, beyond dance clubs, is associated with frequent drug use. This stresses the importance of targeted prevention in various recreational venues tailored to the specific needs of the setting and its visitors.

Copyright 2011, BioMed Central

Waitt G; Jessop L; Gorman-Murray A. 'The guys in there just expect to be laid': Embodied and gendered socio-spatial practices of a 'night out' in Wollongong, Australia. Gender, Place and Culture 18(2): 255-275, 2011. (43 refs.)

This article investigates intersections of sexuality, sex, femininities, and alcohol. The concept of spatially-situated subjectivity is deployed to examine how women negotiate their femininities and sexualities in and through spaces of a 'night out'. A mixed methods approach was deployed with young, single, white women in Wollongong, Australia. Drawing on narrative analysis, our research suggests the paradoxical qualities of pub spaces. We argue that where and why women drink is an outcome of negotiations, transgressions and accommodations as they reconcile a sense of self with(in) the gendered and heterosexed socio-spatial practice of particular pubs. In practical terms, corporeal femininities provide effective advice for ameliorating risks of regular intoxication.

Copyright 2011, Taylor & Francis

Walsh RA; Paul CL; Paras L; Stacey F; Tzelepis F. Workplace-related smoking in New South Wales: Extent of bans, public attitudes and relationships with relapse. Health Promotion Journal of Australia 22(2): 85-90, 2011. (42 refs.)

Issue addressed: Little research has examined issues surrounding employee smoking outside smoke-free workplaces. The study's aims were to: 1) document the proportion of NSW indoor employees covered by total workplace smoking bans; 2) examine community perceptions of employee smoking during working hours; 3) identify the characteristics of having a supportive attitude toward tobacco control in the workplace; and 4) describe relationships between smoking relapse and workplace-related smoking. Methods: Two cross-sectional, computer-assisted telephone interview surveys of randomly selected adults were conducted. Consent rates were 49.1% in 2004 and 45.8% in 2006, with sample sizes of 1,158 and 2,393 respectively. Results: Total workplace bans were reported by 92.9% of indoor employees. Community attitudes to smoking in working hours were highly negative: 77.7% agreed smoking breaks waste too much time and 85.1% opposed smoking near workplace doorways. Being female, born in Australia and a non-smoker were associated with more negative attitudes. A higher proportion of smokers (78.3%) perceived smoking was more common outside their place of work or study than at five other locations: rail/bus stop (60.2%), friends' houses (59.3%), own street (35.2%), parks (34.3%), and outside school (22.6%). Of smokers making a quit attempt in the past year, 42.1% relapsed at home, 22.10/0 at licensed premises and 18.7% at work. Conclusions: Findings emphasise the low support for smoking during or near work. Smoking outside workplaces is highly visible. Data on relapse suggest a modest relationship with workplace-related smoking.

Copyright 2011, Australian Health Promotion Association

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

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

Copyright 2010, Taylor & Francis

Wells S; Graham K; Tremblay PF; Magyarody N. Not just the booze talking: Trait aggression and hypermasculinity distinguish perpetrators from victims of male barroom aggression. Alcoholism: Clinical and Experimental Research 35(4): 613-620, 2011. (62 refs.)

Background: To our knowledge, no research has assessed whether young male victims and perpetrators of barroom aggression differ in terms of their drinking patterns and predisposing characteristics. This study assessed the extent that frequent heavy episodic drinking (HED) and bar-going, trait aggression, and hypermasculinity were differentially associated with victimization versus perpetration for aggression occurring among young adult men in the setting of the public drinking establishment. Methods: A random sample of 2,500 male students attending a local university and a local community college was invited to participate in an online survey. Participants were asked the number of times in the past 12 months they had experienced an incident of aggression at a bar in which (a) someone was physically aggressive toward them and (b) they were physically aggressive toward another person. Responses were coded as (i) any perpetration of aggression, (ii) victim only, (iii) no aggression. A composite variable of HED (5 or more drinks per occasion) and bar-going frequency was computed: (i) both HED and bar >= twice a month, (ii) only HED >= twice a month, (iii) only bar >= twice a month, and (iv) both < twice a month. Standard measures of trait aggression and hypermasculinity were used. Results: Multivariate multinomial logistic regression analyses revealed that a combination of both frequent HED and frequent bar-going was associated with both perpetration and victimization at a bar (compared to no aggression). Trait aggression and hypermasculinity were associated with perpetration but not with victimization. Logistic regression analyses directly comparing perpetrators with victims indicated that perpetrators were more likely to both drink heavily and go to bars frequently and were more likely to have high levels of trait aggression and hypermasculinity. Conclusions: While HED is an important target for prevention programming, additional efforts should be directed toward addressing the combination of frequent HED and frequent bar-going as well as underlying aggressive personalities and masculinity concerns among young men.

Copyright 2011, Research Society on Alcoholism

Wells S; Neighbors C; Tremblay PF; Graham K. Defending girlfriends, buddies and oneself: Injunctive norms and male barroom aggression. Addictive Behaviors 36(4): 416-420, 2011. (28 refs.)

Objective: Research has demonstrated that young adults tend to overestimate their peers' approval of risky behaviors (i.e.. injunctive norms) and that perceived peer approval is associated with actual behavior; however, no empirical studies have assessed injunctive norms in relation to male barroom aggression. The objectives of the present study were to compare young men's own approval of male barroom aggression with their perceptions of approval by male and female peers and to determine the extent that perceived peer approval of male barroom aggression was associated with self-reported physical aggression at a bar, controlling for own approval and heavy episodic drinking. Method: 525 young adult male university and community college students who reported drinking and going to a bar, club or pub rated their own approval and perceptions of peers' approval of bar aggression on items reflecting four domains of approval: (1) general approval, (2) defend self, (3) defend friend and (4) protect girlfriend. Results: For all four domains, participants attributed greater approval to male peers than to themselves. Aggression was positively associated with own approval for all domains and with perceived male peer approval for general approval, defend self and defend friend, controlling for heavy episodic drinking and own approval of aggression. Perceived approval by female peers was not associated with increased likelihood of aggression. Conclusion: The findings suggest that both perceived male peer approval and personal approval are factors associated with male barroom aggression and that addressing approval of barroom aggression is a critical direction for prevention programming.

Copyright 2011, Elsevier Science

Wicki M; Gmel G. Hospital admission rates for alcoholic intoxication after policy changes in the canton of Geneva, Switzerland. Drug and Alcohol Dependence 118(2-3): 209-215, 2011. (43 refs.)

Background: In February, 2005, the canton of Geneva in Switzerland prohibited the off-premise sale of alcoholic beverages between 9pm and 7am, and banned their sale in gas stations and video stores. The aim of this study is to assess the impact of this policy change on hospital admission rates for alcoholic intoxication. Methods: An interrupted time series analysis of this natural experiment was performed with data on hospitalisations for acute alcoholic intoxication during the 2002-2007 period. The canton of Geneva was treated as the experimental group, while all other Swiss cantons were used as the control group. Results: In the experimental site, the policy change was found to have a significant effect on admission rates among adolescents and young adults. Depending on the age group, hospitalisation rates for alcoholic intoxication fell by an estimated 25-40% as the result of restricted alcohol availability. Conclusions: Modest restrictions on opening hours and the density of off-premise outlets were found to be of relevance for public health in the canton of Geneva. In light of this finding, policy makers should consider such action as a promising approach to alcohol prevention.

Copyright 2011, Elsevier Science

Williams M; Mohsin M; Weber D; Jalaludin B; Crozier J. Alcohol consumption and injury risk: A case-crossover study in Sydney, Australia. Drug and Alcohol Review 30(4): 344-354, 2011. (54 refs.)

Introduction and Aims. Alcohol contributes to traumatic outcomes that kill or disable at a relatively young age, resulting in the loss of many years of life or disability. Harm from alcohol consumption can result from chronic or acute alcohol use. The aims of this study are to determine the prevalence of alcohol-related injury and contextual factors contributing to injury risk in an ethnically diverse population of Sydney. Design and Methods. The study was undertaken in emergency departments of six hospitals between 2005 and 2006 and used a case-crossover design. The 1599 attendees surveyed (response rate 64.2%) were aged over 14 years and had presented with an injury to the emergency department. Results. Attendees were predominantly male, young, 40% spoke a language other than English at home and 17% had been drinking in the 6 h prior to their injury. Those born overseas drank at lower levels than their Australian born counterparts. The risk of sustaining an injury was 1.42 times greater in attendees consuming alcohol compared with those who had not. At very high intake levels (>90 g) the risk of injury was statistically significant for both men and women (men odds ratio: 1.88, 95% confidence interval: 1.46-2.42; women odds ratio: 1.89, 95% confidence interval: 1.04-3.43). Drinking at a licensed premise and drinking alone or with a group of people also significantly increased the risk of injury. Discussion and Conclusions. The results support current Australian policy concerning alcohol but indicate that further restrictions and increased warnings for the community may be warranted.

Copyright 2011, Wiley-Blackwell

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

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

Copyright 2010, Wiley-Blackwell