Local environmental alcohol licencing strategies
At a glance
Country of origin
- United Kingdom
Level(s) of intervention
- Environmental prevention
Local strategies to intensify the licensing enforcement — aimed both at regulating the availability of alcohol and modifying the drinking environment — can reduce alcohol-related harms such as hospital admissions, violent crimes, sexual crimes and public order offences. This kind of regulatory intervention is replicable (in countries where municipalities or counties have regulatory power and decision latitude), with results that are likely to be transferable. In none of the studies was any intervention developer involved. The interventions and their dosage are clearly described and defined but can be deployed in different ways as interventions. There are also no promotion or direct costs or commercial interests.
Keywords
alcoholLinks to this programme in other registries
Implementation Experiences
Read the experiences of people who have implemented this programme.Contact details
Main author of studies (not intervention developer):
F de Vocht, School of Social and Community Medicine, University of Bristol,
frank.devocht[at]bristol.ac.uk
Overview of results from the European studies
Studies overview
Licensing data were obtained at local level from the Home Office Alcohol and Late Night Refreshment Licensing data and local areas were coded as ‘passive’, low, medium or highly active based on whether they made use of cumulative impact areas and/or whether any licences for new premises were declined. These data were linked to 2009–2015 alcohol-related hospital admission and alcohol-related crime rates obtained from the Local Alcohol Profiles for England. Population size and deprivation data were obtained from the Office of National Statistics. Changes in directly age-standardised rates of people admitted to hospital with alcohol-related conditions were analysed using hierarchical growth modelling.
Stronger reductions in alcohol-related admission rates were observed in areas with more intense alcohol licensing policies, indicating an ‘exposure–response’ association, in the 2007–2015 period. Local areas with the most intensive licensing policies had an additional 5% reduction (p=0.006) in 2015 compared with what would have been expected had these local areas had no active licensing policy in place (De Vocht et al. 2016).
Local areas in England with more intense alcohol licensing policies had also a stronger decline in rates of violent crimes, sexual crimes and public order offences in the period up to 2013 of the order of 4–6% greater compared with areas where these policies were not in place, but not thereafter (De Vocht et al. 2017b).
An experimental design study used Home Office licensing data (2007– 2012) to identify (1) interventions: local areas where both a cumulative impact zone and increased licensing enforcement were introduced in 2011; and (2) controls: local areas with neither. Outcomes were 2009–2015 alcohol-related hospital admissions, violent and sexual crimes, and antisocial behaviour. Bayesian structural time series were used to create post-intervention synthetic time series (counterfactuals) based on weighted time series in control areas. Intervention effects were calculated from differences between measured and expected trends and showed moderate reductions in alcohol-related hospital admissions and violent and sexual crimes associated with introduction of local alcohol licensing policies (de Vocht et al. 2017a).
Using the same analytic methods (Bayesian structural time–series), a paper with three natural experiments in English local areas of 1000–15000 people each evaluated the impact of local licencing interventions at small spatial scale by using a causal inference framework. Interventions were (a) the closure of a nightclub following reviews; (b) closure of a restaurant/nightclub following reviews and (c) implementation of new local licensing guidance (LLG). Data from emergency department admissions, ambulance call-outs and alcohol-related crime at the lower or middle geographical aggregation level showed that a) closure of the nightclub led to temporary 4-month reductions in antisocial behaviour with no change in other outcomes, b) closure of the restaurant/nightclub did not lead to measurable changes in outcomes, while c) the new licensing guidance led to small reductions in drunk and disorderly behaviour (nine of a predicted 21 events averted), and the unplanned end of the LLG coincided with an increase in domestic violence of two incidents per month (De Vocht el al. 2020).
With an inverted design, a study in Brabant, NL (de Goeij et al. 2017) assessed how youth alcohol consumption trends were related to the development and implementation of integrated policies: six municipalities with stronger declines in youth alcohol consumption between 2007 and 2011 (cases) were compared to four municipalities with weaker declines (controls). Information on the policy process in the same period was obtained through semi-structured in-depth interviews with policy advisors and extracted from policy documents. Municipalities with stronger declines in alcohol consumption involved sectors other than public health and had started to implement interventions that use regulatory or enforcement strategies. Their involvement was facilitated by framing youth alcohol consumption as a safety rather than a health problem, whereby local media played a substantial role.
Countries where evaluated
- Netherlands,
- United Kingdom
Characteristics
Protective factor(s) addressed
- Environmental physical: Reducing outlet density
- Environmental: Comprehensive and strict local alcohol policy and enforcement
- Environmental: Enforcement strategy in on-site alcohol-selling premise
- Environmental: RBS (Responsible Beverage Service) available
- Environmental: Restriction of opening hours
- Community: other
Risk factor(s) addressed
- Community: laws and norms favourable to substance use and antisocial behaviour
- Community: perceived availability of drugs/alcohol
- Environmental physical: High density of alcohol-selling off-site premises
- Environmental physical: High density of licensed alcohol-on-site premises
- Environmental physical: Level of crowdedness in on-site alcohol-selling premise
- Environmental physical: Low alcohol policy comprehensiveness and enforcement
Outcomes targeted
- Emergency visits
- Crime
- Other behaviour outcomes
- Sexual violence
- Social behaviour (including conduct problems)
- Violence
Description of programme
Local authorities in England (United Kingdom) and in other countries have regulatory powers to influence the local alcohol environment by modifying the licensing process and controlling the enforcement of existing licenses (but not, for example, to set levels of tax). Such interventions include, for example, defining cumulative impact zones (CIZs) where there is cumulative stress caused by excess alcohol supply. CIZs and restrictions on new licenses shall regulate the availability of alcohol and change the drinking environment. Applicants for a new alcohol license have to demonstrate how they will avoid causing harm, hence reversing the burden of proof.
Two studies showed a linear dose-response relationship between the intensity of such regulatory strategies and reduced alcohol-related harm. One study confirmed this in a quasi-experimental controlled design, and another one showed in three local experiments that the impact of local alcohol regulations, even at the level of individual premises, can be evaluated using a causal inference framework and that even single interventions such as closure or restriction of alcohol venues and alcohol licensing may have a positive impact on health and crime in the immediate surrounding area. One reversed case-control study (where intervention intensity is the dependent variable) confirms the findings in one Dutch context.
