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Reducing intoxication among bar patrons: some lessons from prevention of drinking and driving

Authors

  • Kathryn Graham,

    Corresponding author
    1. Social and Epidemiological Research, Centre for Addiction and Mental Health, London, ON, Canada
    2. Western University, London, ON, Canada
    3. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
    4. National Drug Research Institute, Curtin University, Perth, WA, Australia
    • Correspondence to: Kathryn Graham, Centre for Addiction and Mental Health, 100 Collip Circle, Suite 200, London, Ontario, Canada N6G 4X8. E-mail: kgraham@uwo.ca

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  • Peter Miller,

    1. Social and Epidemiological Research, Centre for Addiction and Mental Health, London, ON, Canada
    2. National Drug Research Institute, Curtin University, Perth, WA, Australia
    3. School of Psychology, Deakin University, Geelong, VIC, Australia
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  • Tanya Chikritzhs,

    1. Social and Epidemiological Research, Centre for Addiction and Mental Health, London, ON, Canada
    2. National Drug Research Institute, Curtin University, Perth, WA, Australia
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  • Mark A. Bellis,

    1. Centre for Public Health, Liverpool John Moores University, Liverpool, UK
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  • John D. Clapp,

    1. College of Social Work, The Ohio State University, Columbus, OH, USA
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  • Karen Hughes,

    1. Centre for Public Health, Liverpool John Moores University, Liverpool, UK
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  • Traci L. Toomey,

    1. School of Public Health, University of Minnesota, Minneapolis, MN, USA
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  • Samantha Wells

    1. Social and Epidemiological Research, Centre for Addiction and Mental Health, London, ON, Canada
    2. Western University, London, ON, Canada
    3. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Abstract

Intoxication in and around licensed premises continues to be common, despite widespread training in the responsible service of alcohol and laws prohibiting service to intoxicated individuals. However, research suggests that training and the existence of laws are unlikely to have an impact on intoxication without enforcement, and evidence from a number of countries indicates that laws prohibiting service to intoxicated individuals are rarely enforced. Enforcement is currently hampered by the lack of a standardized validated measure for defining intoxication clearly, a systematic approach to enforcement and the political will to address intoxication. We argue that adoption of key principles from successful interventions to prevent driving while intoxicated could be used to develop a model of consistent and sustainable enforcement. These principles include: applying validated and widely accepted criteria for defining when a person is ‘intoxicated’; adopting a structure of enforceable consequences for violations; implementing procedures of unbiased enforcement; using publicity to ensure that there is a perceived high risk of being caught and punished; and developing the political will to support ongoing enforcement. Research can play a critical role in this process by: developing and validating criteria for defining intoxication based on observable behaviour; documenting the harms arising from intoxication, including risk curves associated with different levels of intoxication; estimating the policing, medical and social costs from intoxicated bar patrons; and conducting studies of the cost-effectiveness of different interventions to reduce intoxication.

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