tag:theconversation.com,2011:/ca/topics/alcohol-related-harm-9361/articlesAlcohol-related harm – The Conversation2024-02-12T05:53:46Ztag:theconversation.com,2011:article/2232932024-02-12T05:53:46Z2024-02-12T05:53:46ZWhy it’s a bad idea to mix alcohol with some medications<figure><img src="https://images.theconversation.com/files/574811/original/file-20240211-26-dgcv36.jpg?ixlib=rb-1.1.0&rect=40%2C130%2C6669%2C4335&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/senior-man-taking-prescription-medicine-home-1768003094">pikselstock/Shutterstock</a></span></figcaption></figure><p>Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do. </p>
<p>But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.</p>
<p>When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.</p>
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Read more:
<a href="https://theconversation.com/hilda-survey-at-a-glance-7-charts-reveal-were-smoking-less-taking-more-drugs-and-still-binge-drinking-223004">HILDA survey at a glance: 7 charts reveal we're smoking less, taking more drugs and still binge drinking</a>
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<h2>How alcohol and medicines interact</h2>
<p>The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to <a href="https://www.medicalnewstoday.com/articles/324330">convulsions</a>. Too much inhibition and you will experience effects like sedation and depression.</p>
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<p>Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks. </p>
<p>With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep. </p>
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<img alt="Woman collects beer bottles" src="https://images.theconversation.com/files/574812/original/file-20240211-16-viubsu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574812/original/file-20240211-16-viubsu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574812/original/file-20240211-16-viubsu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574812/original/file-20240211-16-viubsu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574812/original/file-20240211-16-viubsu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574812/original/file-20240211-16-viubsu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574812/original/file-20240211-16-viubsu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Alcohol can affect the way a medicine works.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/a-group-of-people-standing-around-a-table-with-green-bottles-BeSMeRIrrDQ">Jonathan Kemper/Unsplash</a></span>
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<p>Medications can interact with alcohol to <a href="https://awspntest.apa.org/record/2022-33281-033">produce different or increased effects</a>. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those <a href="https://www.drugs.com/article/medications-and-alcohol.html#:%7E:text=Additive%20effects%20of%20alcohol%20and,of%20drug%20in%20the%20bloodstream.">effects can be compounded</a>. </p>
<p>Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can <a href="https://www.healthline.com/health/adhd/ritalin-and-alcohol#side-effects">increase the drug’s effect on the heart</a>, increasing your heart rate and the risk of a heart attack. </p>
<p>Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds. </p>
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Read more:
<a href="https://theconversation.com/whats-happening-to-us-when-we-get-drunk-51245">What's happening to us when we get drunk?</a>
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<p>Alcohol can increase the break-down of certain medicines, such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763421005121?via%3Dihub">opioids, cannabis, seizures, and even ritalin</a>. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with <a href="https://australianprescriber.tg.org.au/articles/alcohol-and-paracetamol.html">paracetamol</a>. </p>
<p>At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.</p>
<h2>Who is at most risk?</h2>
<p>The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size. </p>
<p>Older people do not break down medicines as quickly as younger people, and are often on <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over#:%7E:text=is%20this%20important%3F-,Polypharmacy%20is%20when%20people%20are%20using%20five%20or%20more%20medicines,take%20five%20or%20more%20medicines.">more than one medication</a>. </p>
<p>Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls. </p>
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<img alt="Woman sips red wine" src="https://images.theconversation.com/files/574809/original/file-20240211-24-ckwjbj.jpg?ixlib=rb-1.1.0&rect=321%2C47%2C7618%2C5249&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574809/original/file-20240211-24-ckwjbj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574809/original/file-20240211-24-ckwjbj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574809/original/file-20240211-24-ckwjbj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574809/original/file-20240211-24-ckwjbj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574809/original/file-20240211-24-ckwjbj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574809/original/file-20240211-24-ckwjbj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Smaller and older people are often more affected.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/woman-drinking-glass-of-wine-I-_Zmz6G6PU">Alfonso Scarpa/Unsplash</a></span>
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<p>Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.</p>
<h2>What drugs can’t you mix with alcohol?</h2>
<p>You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.</p>
<p>The most common <a href="https://adf.org.au/insights/prescription-meds-alcohol/">alcohol-interacting prescription medicines</a> are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.</p>
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<img alt="" src="https://images.theconversation.com/files/574894/original/file-20240212-26-ltev6a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574894/original/file-20240212-26-ltev6a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574894/original/file-20240212-26-ltev6a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574894/original/file-20240212-26-ltev6a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574894/original/file-20240212-26-ltev6a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574894/original/file-20240212-26-ltev6a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574894/original/file-20240212-26-ltev6a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Medicines will carry a warning if you shouldn’t take them with alcohol.</span>
<span class="attribution"><span class="source">Nial Wheate</span></span>
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<p>It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain. </p>
<p>Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it. </p>
<p>If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.</p>
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Read more:
<a href="https://theconversation.com/ten-reasons-some-of-us-should-cut-back-on-alcohol-70406">Ten reasons some of us should cut back on alcohol</a>
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<p class="fine-print"><em><span>Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a Fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association, and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vaihea Skincare LLC, a director of SetDose Pty Ltd a medical device company, and a Standards Australia panel member for sunscreen agents. Nial regularly consults to industry on issues to do with medicine risk assessments, manufacturing, design, and testing.</span></em></p><p class="fine-print"><em><span>Kellie Charles was a previous Board Member of the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists. </span></em></p><p class="fine-print"><em><span>Associate Professor Tina Hinton has previously received funding from the Schizophrenia Research Institute (formerly Neuroscience Institute of Schizophrenia and Allied Disorders). She is currently a Board member of the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists.</span></em></p><p class="fine-print"><em><span>Jasmine Lee does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Taking a medicine with alcohol can increase effects like sedation, poor hand and eye coordination, dizziness and poor judgement.Nial Wheate, Associate Professor of the School of Pharmacy, University of SydneyJasmine Lee, Pharmacist and PhD Candidate, University of SydneyKellie Charles, Associate Professor in Pharmacology, University of SydneyTina Hinton, Associate Professor of Pharmacology, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2166012023-11-15T13:16:14Z2023-11-15T13:16:14ZFor decades, mothers have borne the brunt of scrutiny for alcohol use during pregnancy − new research points to dad’s drinking as a significant factor in fetal alcohol syndrome<figure><img src="https://images.theconversation.com/files/558858/original/file-20231110-29-4ks5yo.jpg?ixlib=rb-1.1.0&rect=24%2C36%2C8155%2C5420&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Little to no attention has been given to the father's potential contribution to fetal alcohol syndrome disorders.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/hug-support-and-pregnancy-with-couple-in-living-royalty-free-image/1486895024?phrase=dad+drinking+during+pregnancy&searchscope=image%2Cfilm&adppopup=true">Katleho Seisa/E+ via Getty Images</a></span></figcaption></figure><p>Men drink more, are more likely to binge drink and are almost four times <a href="https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm">more likely to develop alcohol use disorder</a> than women, according to the Centers for Disease Control and Prevention.</p>
<p>Yet when it comes to diagnosing babies born with birth defects associated with alcohol consumption, such as <a href="https://my.clevelandclinic.org/health/diseases/15677-fetal-alcohol-syndrome">fetal alcohol syndrome</a>, historically only the <a href="https://doi.org/10.1542/peds.2015-3113">mother’s drinking habits are taken into consideration</a>.</p>
<p>Research clearly shows that <a href="https://doi.org/10.1016%2Fj.molmet.2018.02.006">sperm carry a vast amount of epigenetic information</a> – meaning heritable shifts in the way genes are expressed that don’t result from changes in the DNA sequence – that strongly influences fetal development and child health. Yet most doctors and other health care providers do not take into account the influence of paternal health and lifestyle choices on child development.</p>
<p>I am <a href="https://scholar.google.com/citations?user=mjARCbsAAAAJ&hl=en">a developmental physiologist</a>, and my research explores the ways that <a href="https://doi.org/10.1002/bdr2.2215">male drinking affects fetal development</a>.</p>
<p>While most of the attention is given to the mom’s drinking while pregnant, my team and I focus on male drinking in the weeks and months before conception. Our studies are the first to demonstrate that male drinking before pregnancy is a <a href="https://doi.org/10.1172/JCI167624">plausible yet completely unexamined factor</a> in the development of alcohol-related craniofacial abnormalities and growth deficiencies. </p>
<h2>The intense focus on mom</h2>
<p>In 1981, the U.S. surgeon general issued a public health warning that <a href="http://come-over.to/FAS/SurgeonGeneral.htm">alcohol use by women during pregnancy</a> was the cause of physical and mental birth defects in children.</p>
<p>This warning came in response to growing recognition that a group of severe physical and mental impairments in children, now commonly known as fetal alcohol syndrome, were <a href="https://pubmed.ncbi.nlm.nih.gov/7250574/">correlated with maternal alcohol use during pregnancy</a>.</p>
<p>Today, doctors and scientists recognize that <a href="https://www.cdc.gov/ncbddd/fasd/1in20.html">as many as 1 in 20 U.S. schoolchildren may exhibit some form</a> of <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-fetal-alcohol-spectrum-disorders#">fetal alcohol spectrum disorders</a>, a term referring to a wide range of <a href="https://www.cdc.gov/ncbddd/fasd/facts.html">alcohol-related physical, developmental and behavioral deficits</a>, many of which cause lifelong challenges for those affected.</p>
<p>According to the CDC, this syndrome can occur when <a href="https://www.cdc.gov/ncbddd/fasd/facts.html">alcohol in the mother’s blood</a> passes to the baby through the umbilical cord. This has led to the firmly <a href="https://www.niaaa.nih.gov/research/fetal-alcohol-spectrum-disorders">accepted</a> belief that alcohol-related birth defects are caused only by maternal alcohol use during pregnancy and are the <a href="https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Fetal-Alcohol-Spectrum-Disorders-FAQs-of-Parents-and-Families.aspx">woman’s</a> fault.</p>
<p>The medical community reinforces this perception by requiring pediatricians to compel mothers to confirm and document their prenatal alcohol use before they can formally diagnose children with <a href="https://doi.org/10.1542/peds.2015-3113">alcohol-related birth defects</a> or <a href="https://www.cdc.gov/ncbddd/fasd/features/neurobehavioral-disorder-alcohol.html">neurobehavioral disorders associated with prenatal alcohol exposure</a>. Nonetheless, there are multiple documented instances in which children diagnosed with fetal alcohol syndrome were born to mothers who denied that they consumed alcohol during pregnancy.</p>
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<figcaption><span class="caption">Fetal alcohol syndrome disorder can take a variety of forms. For instance, some may struggle with hand-eye coordination, while others have difficulties with emotional regulation.</span></figcaption>
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<p>For example, in one study, 41 mothers denied having consumed <a href="https://doi.org/10.1016%2Fj.drugalcdep.2022.109351">alcohol during pregnancy</a> despite their child receiving a diagnosis of fetal alcohol syndrome. In this circumstance and <a href="https://doi.org/10.1542/peds.2012-1371">others like it</a> over the past 40 years, the <a href="https://doi.org/10.1542/peds.109.5.815">commonly accepted assumption and explanation</a> is that these mothers lied about their alcohol use during pregnancy.</p>
<p>According to the CDC, there is <a href="https://www.cdc.gov/ncbddd/fasd/alcohol-use.html">no known safe amount of alcohol use</a> during pregnancy or while trying to get pregnant. Despite this recommendation, <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-fetal-alcohol-spectrum-disorders">alcohol use during pregnancy</a> is widely reported.</p>
<p>However, reported drinking levels do not directly correlate with a child developing alcohol-related birth defects, and not all women who drink give birth to children with fetal alcohol syndrome. This contradiction has resulted in <a href="https://doi.org/10.1136%2Fbmj.39371.381308.AD">conflicting</a> public <a href="https://doi.org/10.1136%2Fbmj.39356.489340.AD">messaging</a>.</p>
<p>Although differences in how much and when pregnant women drink can contribute to the variation in how fetal alcohol syndrome develops, these factors alone cannot explain the wide range and severity of symptoms. Therefore, unknown factors beyond maternal alcohol use must contribute to this debilitating disorder.</p>
<h2>Dad is the missing piece</h2>
<p>Alcohol is a social drug, so when women drink, they often do so with their male partner. Building from this perspective, my laboratory used a mouse model to determine <a href="https://doi.org/10.1172/JCI167624">what happens if mom, dad or both parents drink</a>. </p>
<p>Fetal alcohol syndrome is associated with <a href="https://doi.org/10.1542/peds.2015-3113">three core birth defects</a>: facial abnormalities, including small eyes and malformations in the middle of the face; reduced growth of the head and brain; and fetal growth restriction, a condition that occurs when babies are born smaller than average. Building on a previous study in humans, we used facial recognition software to study the effects of alcohol consumption on the faces of mice born to mothers, fathers or both parents who consumed alcohol before conception.</p>
<p>In a study published early this year, we captured a <a href="https://doi.org/10.1172/JCI167624">digital image of the mouse’s face</a>. We then digitally assigned facial landmarks, including specific parts of the eyes, ears, nose and mouth. The computer program then determined if maternal, paternal or dual parental alcohol exposures changed the proportional relationships between each of these landmarks.</p>
<p>Our study using this mouse model revealed that chronic male alcohol exposure affects the <a href="https://doi.org/10.1172/JCI167624">formation of the offspring’s brain, skull and face</a>. We also observed <a href="https://www.cdc.gov/ncbddd/birthdefects/microcephaly.html#">microcephaly</a>, the underdevelopment of the head and brain, as well as lower birth weight, which became worse the more the male parent drank.</p>
<p>Therefore, our studies demonstrate that chronic male alcohol exposure – defined as consuming more than five drinks per day in a four-hour window – could drive all three of the core fetal alcohol syndrome birth defects.</p>
<p>Using this same mouse model, we also determined that these <a href="https://doi.org/10.1172/JCI174216">craniofacial changes persist into later life</a>. Specifically, we identified abnormalities in the jaw and the size and spacing of the adult teeth. Abnormal alignment of the upper and lower teeth is another <a href="https://doi.org/10.1093/alcalc/agy071">recognized symptom of fetal alcohol syndrome in humans</a>.</p>
<p>Besides our research, other studies have identified <a href="https://doi.org/10.1016/j.alcohol.2015.02.008">behavioral changes in the offspring</a> of male mice who regularly consume alcohol. In addition, clinical studies suggest that paternal drinking <a href="https://doi.org/10.1001/jamapediatrics.2021.0291">increases the risk of heart defects</a> in people. </p>
<h2>Effects on male fertility and pregnancy</h2>
<p>Our studies also support more <a href="https://doi.org/10.1093/molehr/gaad002">immediate impacts of alcohol consumption on male fertility</a> and the ability of couples to <a href="https://doi.org/10.3389/fcell.2022.930375">achieve a healthy pregnancy</a>. These observations may be especially relevant for couples struggling to have children.</p>
<p>The CDC estimates that about 2% of all babies born in the U.S. are <a href="https://www.cdc.gov/art/index.html">conceived using assisted reproductive technologies</a>. While the focus of in-vitro fertilization treatments <a href="https://www.cdc.gov/art/ivf-success-estimator/index.html">remains maternal health and lifestyle choices</a>, our studies reveal that male alcohol exposure decreases the chance of becoming pregnant after undergoing IVF.</p>
<p>Significantly, our research showed that the more a man drinks before providing sperm, the <a href="https://doi.org/10.1093/molehr/gaad002">lower the chances of his partner becoming pregnant</a> – in some cases, by almost 50%. </p>
<h2>Looking ahead</h2>
<p>Annual estimates suggest that the cumulative costs of fetal alcohol spectrum disorders to the health care and educational systems range from <a href="https://doi.org/10.1111/add.14841">US$1.29 billion to $10.1 billion annually</a>. Given these exorbitant costs and the devastating lifelong effects on affected individuals, ignoring paternal drinking habits in public health messaging overlooks a significant contributing factor.</p>
<p>The first published investigations into the effects of maternal exposure to toxins on birth defects in the 1950s and ’60s were met with skepticism and disbelief. Today, it is widely accepted that <a href="https://doi.org/10.1542/peds.113.S3.935">maternal exposures to certain drugs</a> cause birth defects.</p>
<p>I fully anticipate that some within the medical and scientific communities, as well as the public, will forcefully deny that paternal drinking matters. However, until doctors start asking the father about his drinking, we will never fully know the contributions of paternal alcohol exposure to birth defects and child health.</p><img src="https://counter.theconversation.com/content/216601/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Golding receives funding from the National Institutes of Health (R01AA028219) and a Medical Research Grant from the W.M. Keck Foundation. </span></em></p>Public health messaging has focused on the drinking habits of the mother during pregnancy. But a growing body of research shows that what dad is drinking before pregnancy matters too.Michael Golding, Professor of Physiology, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2075712023-06-28T20:47:28Z2023-06-28T20:47:28ZAdolescent drinking rates remain high in China despite ban<figure><img src="https://images.theconversation.com/files/533573/original/file-20230622-15-lpw9jw.jpg?ixlib=rb-1.1.0&rect=0%2C616%2C6237%2C3529&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Improved efforts are needed to prevent underage drinking and challenge lenient attitudes toward alcohol. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>There are plenty of health concerns for teens to worry about these days: the effects of <a href="https://theconversation.com/vaping-is-an-urgent-threat-to-public-health-112131">e-cigarette</a> and <a href="https://nida.nih.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders">cannabis use</a>, and how <a href="https://doi.org/10.1136/bmj.m4691">drinking could harm</a> their <a href="https://doi.org/10.1002%2Fwps.20786">developing brains</a>. </p>
<p>Although relatively more is known about youth drinking in the West, there is a significant knowledge gap when it comes to China, home to the world’s second-largest <a href="https://www.undp.org/china/youth">youth population</a>. </p>
<p>To learn more about how Chinese teens engage with alcohol, we conducted a systematic review of studies on teen drinking behaviours in China over a 30-year period from 1988 to 2018.</p>
<p><a href="https://doi.org/10.1016/j.ypmed.2023.107558">In our recently published study</a>, we found high levels of drinking among Chinese adolescents aged 12 to 17 years old. Around half of Chinese teens reported having consumed alcohol at some point. One in four reported drinking in the past month and one in 10 reported binge drinking. </p>
<p>These drinking rates, while significant, are in fact lower than those reported by <a href="https://www.emcdda.europa.eu/publications/joint-publications/espad-report-2019_en">European</a>, <a href="https://files.eric.ed.gov/fulltext/ED611736.pdf">American</a> and <a href="https://statistique.quebec.ca/en/fichier/enquete-quebecoise-tabac-alcool-drogue-jeu-eleves-secondaire-2019.pdf">Canadian</a> teens.</p>
<p>A second key finding is that teen drinking has not declined since <a href="http://www.chinadaily.com.cn/english/doc/2006-01/06/content_510002.htm">China set the legal drinking age at 18 years old</a> in 2006. This suggests that efforts to reduce underage drinking have not been as effective as intended.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="People clinking beer glasses" src="https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Teen drinking has not declined since China set the legal drinking age at 18 years old in 2006.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Underage drinking</h2>
<p>People who start drinking younger are much more likely to develop <a href="https://doi.org/10.1111/j.1530-0277.2008.00806.x">alcohol-related</a> problems later in life. This means delaying the start of alcohol use should be a high priority for authorities. Drinking during adolescence, especially heavy drinking, can cause <a href="https://doi.org/10.1007/s11920-016-0689-y">functional and structural</a> brain changes that have long-term consequences for a person’s <a href="https://www.ncbi.nlm.nih.gov/books/NBK37610/">health and well-being</a>. Our analysis shows there is an urgent need for effective preventive measures to reduce underage drinking in China.</p>
<p>To examine drinking rates among Chinese teens, we reviewed all studies on teen drinking behaviours published in English and Chinese over the past three decades. We <a href="https://doi.org/10.1016/j.ypmed.2023.107558">identified</a> 186 relevant studies. Nine different measures of drinking were examined, such as lifetime drinking, past month drinking, past year drinking and binge drinking.</p>
<p>We found that around 25 per cent of Chinese teens reported drinking in the past month. This is close to the <a href="https://doi.org/10.1002%2Fwps.20786">worldwide average</a> for teens aged 15–19 years. However, it is lower than rates for European teens aged 15–16 years (48 per cent), American adolescents in grade 12 (29 per cent), and Québecois adolescents in grades 7 to 11 (32 per cent).</p>
<p>Another interesting finding was that Chinese male teens consistently reported higher rates of drinking than female teens. This pattern contrasts with trends observed in Europe and North America, where the gender gap in drinking behaviours has <a href="https://www.emcdda.europa.eu/publications/joint-publications/espad-report-2019_en">been narrowing</a>.</p>
<h2>Chinese teens still drinking</h2>
<p>We found no evidence that rates of teen drinking declined following China’s implementation of the ban on underage drinking. This contrasts with trends across 30 European countries, where the frequency of drinking among most teens has <a href="https://www.emcdda.europa.eu/publications/joint-publications/espad-report-2019_en">declined</a> over the past 25 years, though not when it comes to binge drinking.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man's hand refusing to take a glass." src="https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Tackling attitudes toward alcohol can help reduce drinking among teens.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Similar patterns have been observed in <a href="https://doi.org/10.9778%2Fcmajo.20150124">Canada</a>, where rates of binge drinking increased from 1996 to 2013, although no increase was observed for low-risk drinking behaviours. In the United States, <a href="https://files.eric.ed.gov/fulltext/ED615087.pdf">drinking</a> among eighth to 12th grade students, including binge drinking, has <a href="https://files.eric.ed.gov/fulltext/ED611736.pdf">declined</a> over the past three decades.</p>
<p>One important question is why the Chinese government’s approach has not succeeded when <a href="https://doi.org/10.1016/j.drugpo.2022.103606">similar policies in other countries have</a>. One possibility is weak or inconsistent enforcement of the underage drinking ban. This may have to do with cultural norms, which are <a href="https://doi.org/10.1111/j.1360-0443.2011.03514.x">more</a> <a href="https://doi.org/10.1093/alcalc/agg111">permissive</a> towards alcohol.</p>
<h2>Reducing teen drinking</h2>
<p>Prevention strategies that have proven effective in other countries should be adapted to the Chinese context. These could include <a href="https://doi.org/10.1016/j.drugalcdep.2018.05.031%22%22">family-</a> and <a href="https://doi.org/10.1542/peds.2007-2243E">school-based</a> <a href="https://doi.org/10.1016/j.jadohealth.2016.06.021">programs</a>, along with public education campaigns.</p>
<p>Although rates of drinking are lower among Chinese adolescents than in some western countries, they do not show the same downward trend. Further efforts to reduce teen drinking are therefore needed.</p>
<p>Stricter policy enforcement should come with additional measures to reduce easy <a href="https://doi.org/10.1016%2Fj.amepre.2009.11.005">access to alcohol</a>. Reshaping lenient cultural norms and attitudes towards underage alcohol as well as <a href="https://doi.org/10.1080/13669877.2013.788545">risk perception</a> towards alcohol is also important.</p>
<p>Drinking can offer some benefits and is often a basis for social <a href="https://theconversation.com/canadas-new-drinking-guidelines-dont-consider-the-social-benefits-of-alcohol-but-should-they-198379">connection</a>. Getting teens to delay drinking is arguably a more <a href="https://doi.org/10.1016/S0306-4603(02)00294-0">realistic</a> goal than advocating complete abstinence.</p>
<p>China has a large youth population and even small shifts in social policy and substance use norms could deliver large benefits for the health of individuals and society.</p><img src="https://counter.theconversation.com/content/207571/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Teen drinking has not declined in the years since China banned underage drinking. Better enforcement and changes in attitudes to alcohol are needed.Francis Vergunst, Associate Professor, Psychosocial Difficulties, University of OsloYao Zheng, Assistant Professor, Department of Psychology, University of AlbertaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2057002023-05-29T13:10:10Z2023-05-29T13:10:10ZDrink up, it’s closing time: South African study calculates that limiting opening hours will save lives<figure><img src="https://images.theconversation.com/files/527034/original/file-20230518-17-8xdcj5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Cristi Lucaci/Shutterstock</span></span></figcaption></figure><p>South Africans are among the heaviest drinkers in the world. The country has the highest per capita rate of <a href="https://www.who.int/publications/i/item/9789241565639">alcohol consumption</a> in Africa. Excessive drinking is especially widespread in the Western Cape. Research <a href="https://dgmt.co.za/wp-content/uploads/2023/02/Minumum-Unit-Pricing-Phase-1.1-Modelling-Impact-of-MUP-15112021-FINAL-1.pdf">estimates</a> that per capita alcohol consumption in the province is between 30% and 40% higher than the national consumption. </p>
<p>Alcohol use contributes to <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7771-4">over 200</a> different diseases, injuries and conditions. It is also a risk factor for gender-based violence and <a href="https://www.westerncape.gov.za/assets/departments/health/mortality_profile_2016.pdf">violent crime</a>. </p>
<p>In a bid to reduce alcohol-related harms in the province, the Western Cape government has <a href="https://www.westerncape.gov.za/text/2017/September/white_paper_alcohol-related_harms_reduction.pdf">proposed</a> a policy to restrict trading hours for onsite alcohol consumption. International <a href="https://pubmed.ncbi.nlm.nih.gov/28647704/">research</a> shows that reducing trading hours is an effective way to curb alcohol consumption and its associated harms. This type of policy is also supported by the <a href="https://apps.who.int/iris/bitstream/handle/10665/259232/WHO-NMH-NVI-17.9-eng.pdf">World Health Organization</a>. </p>
<p>My colleagues and I at the University of Cape Town recently conducted a modelling <a href="https://dgmt.co.za/wp-content/uploads/2023/03/Trading-Hours-Phase-2-Modelling-Trading-Times-Final-Report-vf.pdf">study</a>. We wanted to determine the health and economic impacts of restricting the hours of onsite alcohol consumption. </p>
<p>We considered three latest closing-time scenarios: midnight, 1am and 2am. Data for the model baseline was drawn from national surveys on alcohol consumption, the national treasury’s annual budget reviews and publications from Statistics South Africa and the South African Medical Research Council. </p>
<p>We estimated the impact of each of the proposed closing times on the number of cases and deaths associated with certain health conditions. The study also assessed the policy’s impact on alcohol expenditure, excise tax, value added tax and retail revenue. Finally we estimated the impact on the cost of combating alcohol-related crime in the Western Cape.</p>
<p>Our <a href="https://dgmt.co.za/wp-content/uploads/2023/03/Trading-Hours-Phase-2-Modelling-Trading-Times-Final-Report-vf.pdf">results</a> make it clear that limiting the hours for onsite consumption of alcohol will save lives. It will also prevent alcohol-related diseases and injuries, and reduce hospital and crime prevention costs.</p>
<p>On the other hand, national tax revenue and revenue to the alcohol industry will decrease. </p>
<h2>The findings</h2>
<p>We looked at how the policy might affect public health costs of six alcohol-related conditions. We also factored in the hospital costs of treating these conditions. The conditions we looked at were: road injury; intentional injury; liver cirrhosis; HIV; TB; and breast cancer. </p>
<p>Model estimates suggest that all closing-time scenarios correspond to decreases in six areas. These are: </p>
<ul>
<li><p>alcohol consumption</p></li>
<li><p>number of deaths due to the six alcohol-related conditions</p></li>
<li><p>number of cases of these six conditions</p></li>
<li><p>hospital costs of these conditions</p></li>
<li><p>cost of combating alcohol-related crime</p></li>
<li><p>revenue from alcohol sales and alcohol taxation.</p></li>
</ul>
<p>We estimated how much lower the number of cases of the six conditions would be over the next 20 years. The cases averted were:</p>
<ul>
<li><p>163,800 to 453,000 under the midnight closing-time scenario </p></li>
<li><p>88,700 to 220,300 (1am scenario) </p></li>
<li><p>12,600 to 28,300 (2am scenario). </p></li>
</ul>
<p>Correspondingly, the total hospital cost saving over the next 20 years is between: </p>
<ul>
<li><p>R326.8 million and R890.2 million (midnight scenario)</p></li>
<li><p>R130.5 million and R381.2 million (1am)</p></li>
<li><p>and between R18.7 million and R46.0 million (2am). </p></li>
</ul>
<p>(At the time of publication the <a href="https://www.xe.com/currencyconverter/convert/?Amount=1&From=USD&To=ZAR">exchange rate</a> was R19.42 to the US$) </p>
<p>In the year following the policy’s introduction, tax revenue (excise and value added tax) on alcohol sales is expected to decrease by between R100 million and R333 million under a midnight closing-time scenario. Under the 1am scenario it would fall by between R54 million and R179 million. And in the 2am scenario tax revenue would fall by between R9 million and R27 million. </p>
<p>Retail revenue would decrease by between R328 million and R1,093 million (midnight closing time), between R176 million and R587 million (1am) and between R27 million and R89 million (2am).</p>
<h2>What this all means</h2>
<p>The Western Cape government has expressed a clear commitment to protecting health in the Alcohol Harms Reduction <a href="https://www.westerncape.gov.za/text/2017/September/white_paper_alcohol-related_harms_reduction.pdf">White Paper</a>. Introducing uniform trading-time restrictions for onsite retailers of alcohol is a good first step. </p>
<p>A midnight closing time restriction is the most pro-health policy option.
A 2am closing time is the most pro-industry. But the <a href="https://dgmt.co.za/wp-content/uploads/2023/03/Trading-Hours-Phase-2-Modelling-Trading-Times-Final-Report-vf.pdf">research</a> does suggest that, from a public health standpoint, the 2am closing time still represents a modest improvement on the status quo.</p>
<p>Applying <a href="https://apps.who.int/iris/bitstream/handle/10665/259232/WHO-NMH-NVI-17.9-eng.pdf">evidence-based policies</a> to reduce alcohol consumption is necessary to reduce alcohol-related harms and deaths. The possibility of limited economic costs should not be a deterrent to this policy objective.</p>
<p>The alcohol industry may also point to the direct, indirect and induced job losses resulting from this policy. Concerns about employment losses are genuine and valid. But employment losses are only one side of the issue and should be considered with caution. One needs to consider the overall effects of the policy on employment. Jobs will be created in sectors attracting new demand as people spend some of their money on goods and services other than alcohol. It is nearly impossible to predict the number of jobs that will be created directly because of the policy, or because of the lives saved and lengthened.</p>
<h2>What more needs to be done</h2>
<p>Whatever closing time the government chooses, this policy won’t solve every problem. It will need to be enacted alongside other policy interventions geared towards reducing alcohol consumption and its associated harms. </p>
<p>These policies <a href="https://apps.who.int/iris/bitstream/handle/10665/259232/WHO-NMH-NVI-17.9-eng.pdf">include</a> banning alcohol advertising; adopting a minimum alcohol unit price; reducing the legal limits for drinking and driving; and making it easier for people to get counselling and medically assisted treatment if they struggle with alcohol dependence.</p>
<p>A comprehensive policy framework that targets alcohol consumption at an individual and societal level will be required to combat alcohol-related illness and death, and the adverse health, economic and social consequences.</p><img src="https://counter.theconversation.com/content/205700/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This modelling study on which this article is based was commissioned and funded by the DG Murray Trust, an organisation which Sam has collaborated with as a consultant. Sam Filby works for the Research Unit on the Economics of Excisable Products based at the University of Cape Town. Her research conducted at the University of Cape Town is funded by the African Capacity Building Foundation through the Bill & Melinda Gates Foundation, Tax Justice Network Africa (also through the Bill & Melinda Gates Foundation), the CDC Foundation, and Cancer Research UK. Sam is also CIO of byegwaai, an app-based smoking cessation program. </span></em></p>Alcohol use contributes to over 200 different diseases, injuries, and conditions. It is also a risk factor for gender-based violence and violent crime.Sam Filby, Research Officer, Research Unit on the Economics of Excisable Products, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1950982022-12-15T22:21:29Z2022-12-15T22:21:29ZWant to pre-drink before going out? It probably won’t save you money, and can be risky to boot<figure><img src="https://images.theconversation.com/files/497578/original/file-20221128-16-ee63oq.jpg?ixlib=rb-1.1.0&rect=0%2C194%2C4104%2C2544&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Louis Hansel/Unsplash</span></span></figcaption></figure><p>You’re catching up with a few friends before you go out. Everyone’s having a drink, listening to some tunes, and the mood is good. A ride share is pulling up in the driveway – everyone quickly finishes their drinks and piles into the car, headed to a gig where more alcohol will be consumed. </p>
<p>This is the typical pre-drinking scenario – drinking alcohol in one place, typically someone’s home, before drinking more somewhere else, such as a pub, club or event.</p>
<p>You might be familiar with pre-drinking (colloquially known as <a href="https://www.vichealth.vic.gov.au/media-and-resources/media-releases/experts-warn-against-preloading-on-alcohol-ahead-of-schoolies-week">pre-loading</a>) and think nothing much of doing it.</p>
<p>In reality, it’s a complex behaviour that has been of great interest to health psychologists and public health strategists <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12525">for the past 15 years</a>.</p>
<p>And as popular as it is, pre-drinking isn’t without risk.</p>
<h2>Why do people pre-drink?</h2>
<p>The considerable public health effort to reduce excessive drinking in licensed venues has meant some drinkers appear to have abandoned the traditional “pub to club” model in favour of a “<a href="https://www.emerald.com/insight/content/doi/10.1108/17459261211235119/full/html">home to pub to club” version</a>.</p>
<p>You can understand the appeal – compared to a busy venue, someone’s house is likely to be less noisy, less cramped, and probably doesn’t include a cover charge.</p>
<p>In Australia, a common reason people cite for pre-drinking is the relatively cheaper cost of pre-purchased alcohol compared with prices at a licensed venue.</p>
<p>Indeed, behavioural economists have observed <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.13254">we tend to be quite discerning</a> when figuring out the most cost-effective way to drink.</p>
<p>Add our <a href="https://www.ato.gov.au/business/excise-on-alcohol/lodging,-paying-and-rates---excisable-alcohol/excise-duty-rates-for-alcohol/">complex taxation system</a> and public health initiatives such as <a href="https://industry.nt.gov.au/publications/business/policies/floor-price">minimum unit pricing</a> to the mix, and it’s no surprise we are looking for ways to get a buzz on the cheap.</p>
<h2>More than money?</h2>
<p>Outside Australia, evidence shows alcohol price is less of a driver for pre-drinking. <a href="https://link.springer.com/chapter/10.1007/978-3-030-66941-6_13">Other motivational themes</a> have emerged – mainly from psychological research in North America and Europe. </p>
<p>These include the “enhancement” aspect of pre-drinking itself (as the opening scenario illustrates), controlling alcohol consumption in situ (such as only drinking your preferred brand), or in anticipation of less access to alcohol later on (think long lines for beer at the footy).</p>
<p>Generally, the aim of pre-drinking appears to be getting “sufficiently intoxicated” before going out.</p>
<p>But one motive, commonly mentioned by men, has been labelled as “<a href="https://www.sciencedirect.com/science/article/pii/S0306460315000829">intimate pursuit</a>”. This is where hanging out during pre-drinks is used to built rapport with someone you might be romantically interested in. </p>
<p>Although these themes are generally endorsed by Australian pre-drinkers, cost is still an important driver of our pre-drinking, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12138">especially among young Australians</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/trying-to-cut-back-on-alcohol-heres-what-works-179664">Trying to cut back on alcohol? Here's what works</a>
</strong>
</em>
</p>
<hr>
<p>In <a href="https://link.springer.com/article/10.1007/s10865-014-9573-6">our research</a>, we asked participants about the cheaper cost of pre-drinking, alongside these other motives. It was the strongest predictor of pre-drinking, and also predicted participants’ experience of alcohol-related harm over the previous 12-month period.</p>
<p>Surprisingly, some people report that pre-drinking <a href="https://www.emerald.com/insight/content/doi/10.1108/DAT-12-2013-0055/full/html">doesn’t save them that much money</a>. </p>
<p>From a psychological perspective, this may be because alcohol affects our “<a href="https://link.springer.com/article/10.1007/s00213-008-1284-7">inhibitory control</a>”. Although our goal with having pre-drinks is to keep total alcohol expenditure down, the drunker we get, the harder it is to resist buying another round.</p>
<h2>The unique harm of pre-drinking</h2>
<p>Unfortunately, research consistently shows pre-drinking is uniquely linked to excessive alcohol consumption, and <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12274">alcohol-related harm</a>.</p>
<p>One reason may be that <a href="https://pubmed.ncbi.nlm.nih.gov/18387749/">we drink faster while pre-drinking</a>, relative to sitting on a pint at the pub. This means pre-drinkers may reach higher levels of intoxication, more quickly.</p>
<p>This can be <a href="https://www.sciencedirect.com/science/article/pii/S0306460312003334">highly dependent on a range of factors</a> – for instance, who we are pre-drinking with, and whether or not people are playing drinking games.</p>
<p>Adding to the risk, people tend to be pretty bad at <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1465-3362.2011.00374.x">estimating how much they are drinking</a>. </p>
<p>Sadly, the “sweet spot” of a buzz can quickly give way to increasing levels of alcohol intoxication – and increased risk of alcohol-related harm. </p>
<figure class="align-center ">
<img alt="close-up of friends clinking four beers together" src="https://images.theconversation.com/files/497788/original/file-20221128-20-4gf988.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/497788/original/file-20221128-20-4gf988.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/497788/original/file-20221128-20-4gf988.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/497788/original/file-20221128-20-4gf988.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/497788/original/file-20221128-20-4gf988.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/497788/original/file-20221128-20-4gf988.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/497788/original/file-20221128-20-4gf988.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The more you’ve had to drink, the harder it can be to keep track.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/_8KV86shhPo">Giovanna Gomes/Unsplash</a></span>
</figcaption>
</figure>
<h2>How can pre-drinking risks be minimised?</h2>
<p>Research shows pre-drinking serves important practical and social functions – catching up with friends in a more relaxed environment, and warming up for a night out.</p>
<p>As such, it is unlikely we will eliminate pre-drinking entirely, but we can try to make it a bit less risky. </p>
<p>One challenge for pre-drinking is that people may drink out of whatever vessel is around – say, a mug – and will <a href="https://www.ingentaconnect.com/content/ben/cdar/2008/00000001/00000002/art00007">find it difficult</a> to keep track of their consumption.</p>
<p>Licensed premises serve alcohol in standardised containers such as pints and schooners, or use measured pours. So, having schooners or jiggers on hand when pre-drinking would be a good place to start.</p>
<p>Health psychologists often promote “protective behavioural strategies” – things that help keep our alcohol consumption under control. For example, we can set ourselves a drink limit, or set a timer between drinks to slow our intake. <a href="https://www.tandfonline.com/doi/10.1080/10826084.2019.1686025">Work is ongoing</a> to investigate how these strategies might be better tailored to the pre-drinking context.</p>
<p>Ultimately, if you’re planning a pre-drinking session before an event, it’s a good idea to make sure there are plenty of non-alcoholic or low-alcohol options, and food – <a href="http://www.safeparty.com.au/party-safe-for-hosts/">as you would with any party</a>.</p>
<p>The most important thing pre-drinkers can do is keep an eye on each other, making sure everyone makes it to the event, has a good time, and gets home safely.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/australians-are-embracing-mindful-drinking-and-the-alcohol-industry-is-also-getting-sober-curious-160931">Australians are embracing 'mindful drinking' — and the alcohol industry is also getting sober curious</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/195098/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kim M Caudwell does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>You might think it’s fine to have a few with friends before heading for a night out, but alcohol-related harms actually increase with pre-drinking.Kim M Caudwell, Lecturer - Psychology | Chair, Researchers in Behavioural Addictions, Alcohol and Drugs (BAAD), Charles Darwin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1252272019-10-29T19:24:00Z2019-10-29T19:24:00ZSydney lockout laws review highlights vital role of transparent data analysis<p>The New South Wales Bureau of Crime Statistics and Research (BOCSAR) <a href="https://www.bocsar.nsw.gov.au/Pages/bocsar_media_releases/2019/mr-Impact-lockouts-on-the-CBD.aspx">recently claimed</a> Sydney’s alcohol licensing regulations, commonly known as <a href="https://theconversation.com/au/topics/lockout-laws-26282">lockout laws</a>, reduced non-domestic assaults by 13% in the CBD. Its calculation relied on a decision to allocate 1,837 of these offences to both Kings Cross and the CBD – that is, double-counting the data. <a href="https://www.parliament.nsw.gov.au/ladocs/submissions/63631/Submission%20734%20-%20Centre%20for%20Translational%20Data%20Science,%20University%20of%20Sydney.pdf">Our analysis</a> found this decision was critical to the conclusion that assaults decreased in the CBD. For every other choice about the areas to which offences data were allocated and type of analysis we found no decrease. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/298452/original/file-20191024-119433-7qnb4k.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/298452/original/file-20191024-119433-7qnb4k.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=471&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298452/original/file-20191024-119433-7qnb4k.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=471&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298452/original/file-20191024-119433-7qnb4k.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=471&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298452/original/file-20191024-119433-7qnb4k.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=592&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298452/original/file-20191024-119433-7qnb4k.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=592&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298452/original/file-20191024-119433-7qnb4k.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=592&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Map of Sydney and the entertainment precincts as used by BOCSAR in its analysis: blue – CBD entertainment precinct; red – Kings Cross entertainment precinct; green – nearby displacement areas; yellow – outer displacement areas.</span>
</figcaption>
</figure>
<p><a href="https://www.parliament.nsw.gov.au/ladocs/submissions/63631/Submission%20734%20-%20Centre%20for%20Translational%20Data%20Science,%20University%20of%20Sydney.pdf%5D">Our findings</a> highlight an important question: how do the choices of data collection, pre-processing and analysis affect policy decisions?</p>
<p>The allocation of crimes to areas is just one of several choices made when using data to assess policy impacts. Other choices include how to measure violent crime, what time period to consider and the geographical extent of the areas to include. The question is: if other choices were made, would the results affect a <a href="https://www.abc.net.au/news/2019-09-08/sydney-lockout-laws-rolled-back/11489806">decision to repeal or continue the laws</a>? </p>
<p>Our findings point to the need to follow a couple of principles when using data to inform policymaking. First, the institution that collects data and the institution that analyses the data should be independent of each other. Second,
we need as much transparency about the data and its analysis as possible.</p>
<h2>So what exactly did the analyses show?</h2>
<p>BOCSAR chose to use monthly non-domestic assaults from 2009 onwards. There is nothing wrong with these choices, but others could have been made.</p>
<p>For instance, why from 2009 onwards, not from 2005? Why monthly, not daily? Why reported non-domestic assaults, not reported assaults causing grievous bodily harm? Why divide the area into the CBD and Kings Cross only? </p>
<p>One way of assessing the impact of such choices is to use different subsets of data, different types of data pre-processing and different statistical and/or machine-learning techniques. If the conclusion still remains the same, then our decision is robust to this source of variability. If not, we need to understand why.</p>
<p>For the Kings Cross precinct, the analysis by the Centre for Translational Data Science at the University of Sydney showed the conclusion remained unchanged irrespective of the frequency and period over which data were collected and the analysis performed. Non-domestic assaults had declined following the introduction of the lockout laws in 2014.</p>
<p>For the CBD the reverse was true. Only if we make exactly the same choices as BOCSAR, in particular allocating 1,837 crimes to both the CBD and King Cross, could we conclude non-domestic assaults had decreased very slightly. </p>
<p>Under all other variations of the analyses, including data, methodology and spatial allocation of that data, we found no decrease. Non-domestic assaults in the CBD had been decreasing since 2008 and, if anything, more slowly after the lockout laws took effect. </p>
<p>So why was the inclusion of 1,837 crimes so critical to the conclusions about the CBD? </p>
<p>Using data provided by BOCSAR, we plotted the most likely location of those 1,837 crimes. Figure 1 shows these crimes occurred mainly in Kings Cross, an area in which the crime rate had fallen since 2014. We say “most likely location” because we have yet to receive the additional data we requested from BOCSAR to help us locate exactly where these crimes occurred.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=588&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=588&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=588&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=739&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=739&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298427/original/file-20191023-119429-qgf5xh.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=739&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Counts of crimes (per SA1 region) that were assigned to both the CBD and Kings Cross.</span>
<span class="attribution"><span class="source">Centre for Translational Data Science</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>With the removal of those 1,837 crimes from the CBD, we detected no decrease in non-domestic assaults. But BOCSAR apparently did. After removing those crimes from the CBD, BOCSAR released an <a href="https://www.bocsar.nsw.gov.au/Documents/BB/2019-Report-Effect-of-lockout-and-last-drinks-laws-on-assaults-BB142.pdf">updated report</a> to a <a href="https://www.parliament.nsw.gov.au/committees/listofcommittees/Pages/committee-details.aspx?pk=260">parliamentary inquiry into Sydney’s night-time economy</a>. This report claimed assaults in the CBD decreased by 4% (much less than the original 13%). </p>
<p>The committee then asked for our <a href="https://www.parliament.nsw.gov.au/ladocs/other/12591/Centre%20for%20Translational%20Data%20Science.pdf">comments</a>. We found the report did not provide a confidence interval for this decrease. Yet the report made a virtue of reporting uncertainty estimates for other quantities and elsewhere it claimed “statistically significant” results. </p>
<p>We replicated BOCSAR’s analysis and found the change in crime could have been as low as a 12% decrease and as high as a 6% increase. In other words, the result is “statistically insignificant”. </p>
<h2>What are the implications for making policy?</h2>
<p>Why does this matter? There are two reasons. </p>
<p>First, the danger in not explaining, quantifying and reporting uncertainty is that the public loses trust in data-driven policymaking. Only if conclusions acknowledge and explain the uncertainty inherent in inferring complex quantities from data can we make robust and explainable policy decisions that build trust with the public. </p>
<p>Second, if we don’t accept and report uncertainty we could stop looking for other explanations. We might then fail to achieve an outcome that everyone wants: a reduction in violence and a healthy night-time economy.</p>
<p>How do we proceed from here? We’d make two recommendations: </p>
<ol>
<li><p>The institution that collects and curates the data should be distinct, informed but independent from the institution/s that analyse the data. </p></li>
<li><p>There should be as much data transparency as possible, which would enable different groups to perform different types of analyses, using different sources of data. </p></li>
</ol>
<p>We are almost certain these different groups would produce different findings, but the subsequent discussion could provide insights that move us closer to more robust and acceptable policy decisions. </p>
<p>To <a href="https://www.brainpickings.org/2012/08/27/richard-feynman-on-the-role-of-scientific-culture-in-modern-society/">quote</a> Nobel Prize-winning physicist Richard Feynman:</p>
<blockquote>
<p>If we will only allow that, as we progress, we remain unsure, we will leave opportunities for alternatives … to make progress, one must leave the door to the unknown ajar.</p>
</blockquote>
<p>The <a href="https://www.parliament.nsw.gov.au/ladocs/inquiries/2519/Report%20-%20Sydneys%20night%20time%20economy.pdf">parliamentary committee’s recommendation</a> that BOCSAR and the Centre for Translational Data Science work together more closely appears to do just that. We look forward to an ongoing collaboration to further our understanding of the drivers of violent crime.</p><img src="https://counter.theconversation.com/content/125227/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The collection and analysis of data used for making policy should be independent and open to ensure public trust in decision-making. The debate over alcohol licensing shows why this matters.Sally Cripps, Professor of Statistics, Director of Centre for Translational Data Science, University of SydneyRoman Marchant, Senior research fellow and lecturer, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1211162019-08-13T20:17:52Z2019-08-13T20:17:52ZUnwanted sexual attention plagues young women going out at night<figure><img src="https://images.theconversation.com/files/287453/original/file-20190809-144851-1p50545.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For young women in Queensland, the risk of unwanted sexual attention is high when they go out at night.</span> <span class="attribution"><span class="source">vchalShutterstock</span></span></figcaption></figure><p><em>This is the third in a <a href="https://theconversation.com/au/topics/quantem-74665">series of articles</a> discussing a <a href="http://statements.qld.gov.au/Statement/2019/7/26/evaluation-of-measures-to-tackle-alcoholfuelled-violence">recently released</a> <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">comprehensive evaluation</a> of the Queensland government’s <a href="https://www.legislation.qld.gov.au/view/html/asmade/act-2016-004#">2016 policy reforms to tackle alcohol-fuelled violence</a> and the implications for liquor regulation and the night-time economy in Queensland and Australia. A <a href="http://quantem.info/">summary report</a> is also available.</em></p>
<hr>
<p>A disturbingly high proportion of young people, particularly women, experience unwanted sexual attention in entertainment districts across Queensland. </p>
<p>This is the bad news from a two-year, <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">independent evaluation</a> of the Queensland government’s 2016 “Tackling Alcohol-Fuelled Violence” (TAFV) policy (the good news included a <a href="https://theconversation.com/lessons-from-queensland-on-alcohol-violence-and-the-night-time-economy-121114">significant statewide reduction in serious assaults</a>). </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/lessons-from-queensland-on-alcohol-violence-and-the-night-time-economy-121114">Lessons from Queensland on alcohol, violence and the night-time economy</a>
</strong>
</em>
</p>
<hr>
<p>One in three patrons reported unwanted sexual attention – including harassment, unwanted touching, or sexual gestures – in or around a licensed venue in the preceding three months. Among those who reported unwanted sexual attention, two in three women (68%) also reported physical and/or verbal aggression.</p>
<p>The rate of unwanted sexual attention was highest for young women (ages 18-24). More than 50% had experienced this harm in the previous three months, as the chart below shows.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/286856/original/file-20190805-117861-kq3dkw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286856/original/file-20190805-117861-kq3dkw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=370&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286856/original/file-20190805-117861-kq3dkw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=370&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286856/original/file-20190805-117861-kq3dkw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=370&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286856/original/file-20190805-117861-kq3dkw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=465&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286856/original/file-20190805-117861-kq3dkw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=465&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286856/original/file-20190805-117861-kq3dkw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=465&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Proportion of patrons in Cairns, Fortitude Valley and Surfers Paradise entertainment districts who experienced unwanted sexual attention in the 3 months prior, by sex and age category.</span>
</figcaption>
</figure>
<p>In the Fortitude Valley entertainment district, a staggering one in four reported unwanted sexual attention on the night they were interviewed (26% of 262 female patrons interviewed and followed up the next day).</p>
<p>Over the two-year evaluation, 4,055 patrons (43% female) were interviewed on Saturday nights on the streets of three entertainment districts – Cairns, Fortitude Valley (Brisbane) and Surfers Paradise (Gold Coast). </p>
<p>While the rates fluctuated over time in these areas, the rate of unwanted sexual attention didn’t change when comparing the months before and after the TAFV policy took effect. The chart below shows the trend for Fortitude Valley.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/286857/original/file-20190805-117893-237abq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286857/original/file-20190805-117893-237abq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=331&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286857/original/file-20190805-117893-237abq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=331&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286857/original/file-20190805-117893-237abq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=331&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286857/original/file-20190805-117893-237abq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=416&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286857/original/file-20190805-117893-237abq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=416&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286857/original/file-20190805-117893-237abq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=416&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Proportion of patrons in Fortitude Valley entertainment district who experienced unwanted sexual attention by month and year (June 2016 – June 2018).</span>
</figcaption>
</figure>
<h2>Uncomfortable truths</h2>
<p>These findings highlight some uncomfortable truths. </p>
<p>First, the unwanted sexual attention young women experience in the night-time economy is an intransigent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30991-7/fulltext">public health</a> and safety problem. </p>
<p>Second, the issue is considerably <a href="https://www.tandfonline.com/doi/abs/10.1080/10345329.2012.12035957">under-researched</a>. </p>
<p>Third, overcoming the problem requires discussion beyond alcohol accessibility and drinking practices.</p>
<p>The findings of the evaluation sit against a backdrop of increasing global intolerance of the sexual abuse and harassment of women. For example, the number of women reporting sexual assault to Queensland Police has <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4510.0%7E2018%7EMain%20Features%7EQueensland%7E9">increased for the past six years</a>. This increase might be attributable to the raising of public consciousness (e.g. <a href="https://theconversation.com/metoo-has-changed-the-media-landscape-but-in-australia-there-is-still-much-to-be-done-111612">the “Me Too” campaign</a>).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/metoo-has-changed-the-media-landscape-but-in-australia-there-is-still-much-to-be-done-111612">#MeToo has changed the media landscape, but in Australia there is still much to be done</a>
</strong>
</em>
</p>
<hr>
<p>Such awareness-raising has had impacts on broader social norms around sexual aggression towards women. But the evaluation suggests this messaging has largely failed to permeate the social norms of the night-time economy. </p>
<h2>Why haven’t nightlife norms changed?</h2>
<p>Understanding and addressing the mechanisms behind unwanted social attention in this context is particularly challenging. In addition to the broader social norms, licensed venues have their own cultural norms – including sexualised environments and heavy drinking – that often <a href="https://www.tandfonline.com/doi/abs/10.1080/10345329.2012.12035957">contribute to unwanted sexual attention</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/queenslanders-are-among-our-heaviest-drinkers-on-nights-out-and-changing-that-culture-is-a-challenge-121115">Queenslanders are among our heaviest drinkers on nights out, and changing that culture is a challenge</a>
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</em>
</p>
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<p>Recent experimental research suggests unwanted sexual attention in these settings may be related to males misperceiving the social environmental cues. They read <a href="https://www.tandfonline.com/doi/full/10.1080/14659891.2016.1179804">alcohol presence</a>, <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.12214">alcohol consumption and revealing dress</a> by females as signs of sexual interest. They might have been influenced by decades of sexualised alcohol marketing. </p>
<p>Such research highlights the need to better understand the risk and protective factors affecting victims and perpetrators of sexual aggression, and how these factors interact with cues in the physical environment. </p>
<h2>Responsibility is broadly shared</h2>
<p>These findings have many implications for policy and practice. </p>
<p>For a start, many experiences of unwanted sexual attention sit beyond the boundaries of the law. This raises a number of questions. Who is responsible for acting on unwanted sexual attention in and around licensed venues? And is it time to reassess the <a href="https://www.tandfonline.com/doi/full/10.1080/0966369X.2015.1090413">individualisation of responsibility</a> in entertainment districts?</p>
<p>One strategy that attributes some responsibility to venue staff has been trialled in cities such as London, Chicago, Vancouver and Melbourne. The <a href="http://www.goodnightoutcampaign.org/">Good Night Out initiative</a> aims to train and empower licensed venue staff to act as capable guardians (instead of bystanders) who intervene in incidents of unwanted sexual attention. While theoretically such approaches are promising, the evidence for such targeted strategies remains limited. </p>
<p>The pervasive problem of unwanted sexual attention in night-time economies also requires attention from local and state governments. Strategies that specifically address this harm should be embedded in alcohol policy. </p>
<p>Without a more sophisticated approach that targets all types of aggression, young women will likely continue to experience high rates of unwanted sexual attention on their nights out.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/no-harm-done-sexual-entertainment-districts-make-the-city-a-more-threatening-place-for-women-81091">No harm done? 'Sexual entertainment districts' make the city a more threatening place for women</a>
</strong>
</em>
</p>
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<img src="https://counter.theconversation.com/content/121116/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dominique de Andrade was a member of the research team led by Deakin University (Peter Miller) and University of Queensland (Jason Ferris) to evaluate the Queensland Government’s “Tackling Alcohol-Fuelled Violence” (TAFV) legislation.</span></em></p><p class="fine-print"><em><span>Cheneal Puljevic was a member of the research team led by Deakin University (Peter Miller) and The University of Queensland (Jason Ferris) to evaluate the Queensland Government’s “Tackling Alcohol-Fuelled Violence” (TAFV) legislation.</span></em></p><p class="fine-print"><em><span>Kerri Coomber receives funding from the Australian Research Council, Northern Territory Government, and Queensland Government. </span></em></p><p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Central Australian Aboriginal Congress, Northern Territory government, Australian Rechabites Foundation, Northern Territory Primary Health Network, Lives Lived Well, Queensland government and Australian Drug Foundation, travel and related costs from Queensland Police Service, Queensland Office of Liquor Gaming and Racing and the Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm. </span></em></p>Rates of unwelcome advances haven’t changed under Queensland’s ‘Tackling Alcohol-Fuelled Violence’ policies. In one entertainment district, it happened to 26% of women the night they were interviewed.Dominique de Andrade, The University of QueenslandCheneal Puljević, Research Fellow, Centre for Health Services Research, The University of QueenslandKerri Coomber, Research Fellow, Deakin UniversityPeter Miller, Professor of Violence Prevention and Addiction Studies, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1211152019-08-12T20:03:40Z2019-08-12T20:03:40ZQueenslanders are among our heaviest drinkers on nights out, and changing that culture is a challenge<figure><img src="https://images.theconversation.com/files/287143/original/file-20190807-84240-1kugd6f.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Queenslanders are drinking heavily when they go out and breathalyser tests show most don't realise how drunk they are.</span> </figcaption></figure><p><em>This is the second in a <a href="https://theconversation.com/au/topics/quantem-74665">series of articles</a> discussing a <a href="http://statements.qld.gov.au/Statement/2019/7/26/evaluation-of-measures-to-tackle-alcoholfuelled-violence">recently released</a> <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">comprehensive evaluation</a> of the Queensland government’s <a href="https://www.legislation.qld.gov.au/view/html/asmade/act-2016-004#">2016 policy reforms to tackle alcohol-fuelled violence</a> and the implications for liquor regulation and the night-time economy in Queensland and Australia. A <a href="http://quantem.info/">summary report</a> is also available.</em></p>
<hr>
<p><a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">Our evaluation</a> of the Queensland government’s 2016 “<a href="https://www.thepremier.qld.gov.au/newsroom/alcohol-fuelled-violence.aspx">Tackling Alcohol-Fuelled Violence</a>” (TAFV) policy has found Queenslanders are still drinking more heavily than people in other states when going out at night. </p>
<p>Despite <a href="https://theconversation.com/lessons-from-queensland-on-alcohol-violence-and-the-night-time-economy-121114">significant reductions in serious assaults and other health-related outcomes</a>, reported levels of aggression are also high. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/lessons-from-queensland-on-alcohol-violence-and-the-night-time-economy-121114">Lessons from Queensland on alcohol, violence and the night-time economy</a>
</strong>
</em>
</p>
<hr>
<p>Queenslanders report much higher levels of aggression than reported in our previous studies, which asked the same question in <a href="http://www.deakinvpg.info/dashed">Canberra, Hobart</a>, <a href="http://www.deakinvpg.info/pointed">Melbourne, Sydney, Perth, Wollongong, Geelong</a> and <a href="http://www.deakinvpg.info/dante">Newcastle</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=331&fit=crop&dpr=1 600w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=331&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=331&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=416&fit=crop&dpr=1 754w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=416&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=416&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Table 1. Percentage of interviewees who report being involved in aggression in and around night-time entertainment precincts in the previous three months.</span>
<span class="attribution"><a class="source" href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Female patrons reported experiencing more of all types of aggression than men across all precincts. The next article in this series highlights the worrying number of women who experience unwanted sexual attention while out.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/unwanted-sexual-attention-plagues-young-women-going-out-at-night-121116">Unwanted sexual attention plagues young women going out at night</a>
</strong>
</em>
</p>
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<p>To measure the impact of the 2016 policy changes on alcohol consumption, illicit drug use and aggression, our research teams conducted <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4811-9">street intercept surveys</a> on Saturday nights in Fortitude Valley (Brisbane), Surfers Paradise and Cairns between 2016 and 2018. All participants were breathalysed. Every fifth person was invited to participate in a saliva drug swab. </p>
<p>Across the precincts, 4,401 people – 57% of them male – completed surveys. </p>
<h2>Blood alcohol concentration (BAC)</h2>
<p>Half of patrons’ blood alcohol concentration (BAC in g/dL) readings were over 0.077 (the median value, with a range of 0.000-0.300) in Fortitude Valley, 0.086 (range 0.000-0.290) in Surfers Paradise and 0.087 (range 0.000-0.289) in Cairns. The highest reading, 0.300, is six times the legal driving limit.</p>
<p>These median BAC levels are much higher than other, previously studied cities. The results highlight the challenges of achieving change in Queensland’s drinking culture.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=277&fit=crop&dpr=1 600w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=277&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=277&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=348&fit=crop&dpr=1 754w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=348&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=348&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Table 2. Patrons’ median blood alcohol concentration (BAC in g/dL) and range of readings.</span>
<span class="attribution"><a class="source" href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Interestingly, most patrons are more drunk than they <em>think</em> they are. Before undertaking a breath test patrons were asked to guess their level of intoxication. For example, in Cairns, patrons’ median guess of their BAC reading was 0.070, compared to the measured median of 0.087. </p>
<h2>Pre-drinking</h2>
<p>High alcohol consumption when going out to night-time entertainment precincts includes <a href="https://academic.oup.com/alcalc/article/54/4/378/5486344">pre-drinking</a> (drinking at home before going out; also known as pre-gaming, pre-partying or pre-loading in other countries). As our research teams have documented <a href="http://www.deakinvpg.info/pointed">since 2012</a>, pre-drinking has continued to increase. </p>
<p>With 84% of all patrons reporting pre-drinking before going out, Queensland shows higher levels than in most other previously studied cities. </p>
<p>Overall, male patrons drank significantly more than female patrons when pre-drinking. In Fortitude Valley, though, female patrons were significantly more likely to pre-drink than males.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/womens-alcohol-consumption-catching-up-to-men-why-this-matters-67454">Women's alcohol consumption catching up to men: why this matters</a>
</strong>
</em>
</p>
<hr>
<p>It’s a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12525">common belief</a> that patrons choose to pre-drink to avoid buying more expensive drinks while they’re out in bars or clubs. But we found patrons who reported pre-drinking were more likely to drink more heavily across the night. They also reported drinking for longer than those who did not pre-drink.</p>
<p><a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">Our report</a> also shows the rate of pre-drinking across the precincts remained mostly stable in the two years after the TAFV policy was introduced in 2016. This suggests it did not affect rates of pre-drinking.</p>
<h2>Illicit drug use</h2>
<p>Rates of self-reported illicit drug use varied between precincts, from 13% of patrons in Fortitude Valley to 25% of all patrons in Surfers Paradise.</p>
<p>Ecstasy was the most commonly used illicit substance reported by patrons (5.5%), followed by cannabis (4%).</p>
<p>Among those who completed saliva drug swabs, the most commonly detected substances were amphetamines in Fortitude Valley and Cairns. In Surfers Paradise, however, it was methamphetamine; with 23.5% of patrons interviewed in Surfers Paradise testing positive for the substance.</p>
<p>Although rates of illicit drug use fluctuated in the two years after the TAFV policy was introduced, overall rates remained largely stable. This indicates the policy did not result in a clear increase or decrease in illicit drug use.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fact-check-only-drugs-and-alcohol-together-cause-violence-12466">Fact check: only drugs and alcohol together cause violence</a>
</strong>
</em>
</p>
<hr>
<h2>So what does it all mean?</h2>
<p>Historically, Queensland has high levels of harmful consumption of alcohol, especially in high-risk groups. Around <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001%7E2017-18%7EMain%20Features%7EAlcohol%20consumption%7E100">46% of Queenslanders</a> have exceeded single-occasion risk guidelines in the past year, higher than in New South Wales and Victoria. </p>
<p>There has been significant investment in education campaigns across social media and in schools. Despite this, Queenslanders continue to show hazardous levels of alcohol consumption, illicit drug use and experiences of aggression. </p>
<p>Changing cultural patterns relating to pre-drinking and alcohol-related harms will not be easy. <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/dar.12274">Previous research</a> suggests further tightening of licensed venues’ trading hours will help. Our report recommendations include introducing a <a href="https://www.ncbi.nlm.nih.gov/pubmed/26098040">minimum unit price on alcohol</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/19594797">promoting low-risk drinking guidelines</a> at all points of sale across Queensland. </p>
<p>Our report also recommends trialling live music early in the night to try to bring people into entertainment districts earlier. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/tighter-alcohol-licensing-hasnt-killed-live-music-but-its-harder-for-emerging-artists-121117">Tighter alcohol licensing hasn't killed live music, but it's harder for emerging artists</a>
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</p>
<hr>
<p>Despite the promising results of government policy efforts to date, our evaluation suggests the work to reduce alcohol-related harm across Queensland is not finished. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/factcheck-can-you-change-a-violent-drinking-culture-by-changing-how-people-drink-38426">FactCheck: can you change a violent drinking culture by changing how people drink?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/121115/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jason Ferris receives funding from from Australian Research Council and Australian National Health and Medical Research Council, grants from State (Tasmania, Victoria, Queensland) and Federal Governments, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, University of Queensland, National Institute of Health, Global Drug Survey. He is affiliated with the Global Drug Survey and the Queensland Mental Health Commission.</span></em></p><p class="fine-print"><em><span>Cheneal Puljevic was a member of the research team led by Deakin University (Peter Miller) and The University of Queensland (Jason Ferris) to evaluate the Queensland Government’s “Tackling Alcohol-Fuelled Violence” (TAFV) legislation.</span></em></p><p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Central Australian Aboriginal Congress, Northern Territory government, Australian Rechabites Foundation, Northern Territory Primary Health Network, Lives Lived Well, Queensland government and Australian Drug Foundation, travel and related costs from Queensland Police Service, Queensland Office of Liquor Gaming and Racing and the Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm. </span></em></p><p class="fine-print"><em><span>Barbara Wood does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Even after ‘Tackling Alcohol-Fuelled Violence’ policies took effect in 2016, Queenslanders still drink more heavily on nights out. Reported levels of aggression are higher than in other states too.Jason Ferris, Associate Professor, Program Leader for Research and Statistical Support Service and Program Leader for Substance Use and Mental Health, Centre for Health Services Research, The University of QueenslandBarbara Wood, Research Assistant, The University of QueenslandCheneal Puljević, Research Fellow, Centre for Health Services Research, The University of QueenslandPeter Miller, Professor of Violence Prevention and Addiction Studies, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1211142019-08-11T19:56:47Z2019-08-11T19:56:47ZLessons from Queensland on alcohol, violence and the night-time economy<p><em>This is the first in a <a href="https://theconversation.com/au/topics/quantem-74665">series of articles</a> on a <a href="http://statements.qld.gov.au/Statement/2019/7/26/evaluation-of-measures-to-tackle-alcoholfuelled-violence">recently released</a> <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">comprehensive evaluation</a> of the Queensland government’s <a href="https://www.legislation.qld.gov.au/view/html/asmade/act-2016-004#">2016 policy reforms to tackle alcohol-fuelled violence</a> and the implications for alcohol regulation and the night-time economy in Queensland and Australia. A <a href="http://quantem.info/">summary report</a> is also available.</em></p>
<hr>
<p>Under the “<a href="https://www.thepremier.qld.gov.au/newsroom/alcohol-fuelled-violence.aspx">Tackling Alcohol-Fuelled Violence</a>” policy, which among other things introduced statewide restrictions on trading hours, Queensland has recorded reductions in assaults, ambulance attendances and hospital admissions. These reductions represent a substantial cost saving to the Queensland community. At the same time, tourism and the number of liquor licences have continued to grow in many areas. </p>
<p>Despite this, levels of alcohol-related harm still remain too high, which calls for further effort.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/all-in-it-together-why-stopping-alcohols-harms-needs-everyone-24212">All in it together: why stopping alcohol's harms needs everyone</a>
</strong>
</em>
</p>
<hr>
<p>In this article we describe the report findings from “archival” data – data collected by government services. The next three articles will:</p>
<ul>
<li>describe the data from patron interviews, highlighting levels of intoxication and harm</li>
<li>highlight the unwanted sexual attention reported by patrons</li>
<li>explore the impact on live music.</li>
</ul>
<p>The Queensland government has provided an <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1076.pdf">interim response</a> to the report’s 38 recommendations. Community consultation will continue to the end of 2019. </p>
<h2>What were the 2016 policy changes?</h2>
<p>In 2016, the government responded to community concerns about alcohol-related harm by implementing a multifaceted policy with three broad aims:</p>
<ol>
<li>a safer night-time environment, in particular in entertainment precincts</li>
<li>cultural change, including more responsible drinking practices within designated safe night precincts (SNPs)</li>
<li>a regulatory framework that balances the interests of the liquor industry with a reduction in alcohol-fuelled violence.</li>
</ol>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=413&fit=crop&dpr=1 600w, https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=413&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=413&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=519&fit=crop&dpr=1 754w, https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=519&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/287117/original/file-20190806-84230-1j7v9vp.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=519&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Table 1. Measures introduced as a part of the ‘Tackling Alcohol-Fuelled Violence’ policy (click to enlarge).</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>The policy measures were partly based on the successful “<a href="http://www.ndlerf.gov.au/publications/monographs/monograph-43">Newcastle intervention</a>” in New South Wales. From 2008, Newcastle CBD venues closed at 3.30am and had a 1.30am one-way door (or “lockout”). These changes resulted in steady reductions in harms over time. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/last-drink-laws-not-lockouts-reduce-alcohol-fuelled-violence-52815">‘Last drink’ laws, not lockouts, reduce alcohol-fuelled violence</a>
</strong>
</em>
</p>
<hr>
<p>The measures introduced in Queensland differed from those in Newcastle in four key ways: </p>
<ol>
<li>licensed venues were permitted to remain open after 3am, but not to serve alcohol</li>
<li>the 1.30am one-way door, although originally proposed, was later repealed in light of an <a href="https://www.thepremier.qld.gov.au/newsroom/assets/alcohol-fuelled-violence-six-mth-report.pdf">interim report</a></li>
<li>the government introduced mandatory networked ID scanners</li>
<li>venues were able to apply for up to six extended trading permits allowing trade until 5am (reduced from 12 in February 2017).</li>
</ol>
<p>The measures were implemented in a series of steps, shown in the timeline below. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=211&fit=crop&dpr=1 600w, https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=211&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=211&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=265&fit=crop&dpr=1 754w, https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=265&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/287024/original/file-20190806-84244-yu67r6.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=265&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Timeline for implementing TAFV measures (click to enlarge).</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>How did we measure impact?</h2>
<p>We were able to collect and report on more than 40 datasets. The <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">full report</a> provides detailed methods. The main elements include:</p>
<ol>
<li><p>administrative service and business data (police, ambulance, hospital, liquor licensing, alcohol sales, transport)</p></li>
<li><p>interviews with patrons in the street (including follow-up surveys)</p></li>
<li><p>interviews with key informants (licensees, police, support service workers, doctors, licensing officials etc)</p></li>
<li><p>structured venue observations</p></li>
<li><p>precinct streetscape and business mapping</p></li>
<li><p>foot traffic counting</p></li>
<li><p>ID scanner data</p></li>
<li><p>live music performances (based on events recorded by music rights licensing organisation APRA-AMCOS and Facebook)</p></li>
<li><p>population surveys</p></li>
<li><p>education campaign assessments</p></li>
<li><p>tourism data and survey</p></li>
<li><p>economic evaluation.</p></li>
</ol>
<h2>What did we find?</h2>
<p><strong>SAFETY</strong></p>
<p>After 2016, there were no deaths around licensed venues in a safe night precinct. </p>
<p>Statewide, the rate of serious assaults from 3am-6am fell by 29% per month on average. But serious assaults increased by 19% earlier in the night (8pm to midnight).</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=431&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=431&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=431&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=542&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=542&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286892/original/file-20190805-36399-643l1w.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=542&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 2. Rate of serious assault (per 100,000 population) during high alcohol hours (8pm-6am Friday and Saturday nights), Queensland.</span>
<span class="attribution"><a class="source" href="https://static1.squarespace.com/static/578598c7e4fcb510ac255c7c/t/5d3e38c75339530001bac928/1564358863617/QUANTEM+Final+report+-+Summary_2Apr19.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>A 40% reduction in serious assaults was recorded in Fortitude Valley between 3am and 6am and 35% in Toowoomba (3-6am). Trends were stable elsewhere.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=438&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=438&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=438&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=551&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=551&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286893/original/file-20190805-36403-921jmk.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=551&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 3. Quarterly counts of serious assault during high alcohol hours, Fortitude Valley.</span>
<span class="attribution"><a class="source" href="https://static1.squarespace.com/static/578598c7e4fcb510ac255c7c/t/5d3e38c75339530001bac928/1564358863617/QUANTEM+Final+report+-+Summary_2Apr19.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p><a href="https://apps.who.int/iris/bitstream/handle/10665/66529/WHO_MSD_MSB_00.4.pdf;sequence=1">Alcohol-related</a> ambulance call-outs were reduced significantly statewide: 11% on average per month 3-6am, and in all safe night precincts (29% 3-6am).</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=535&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=535&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286895/original/file-20190805-36386-3c7zo3.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=535&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 4. Rate of monthly alcohol-related ambulance call-outs for Queensland, July 2011 to June 2018.</span>
<span class="attribution"><a class="source" href="https://static1.squarespace.com/static/578598c7e4fcb510ac255c7c/t/5d3e38c75339530001bac928/1564358863617/QUANTEM+Final+report+-+Summary_2Apr19.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Hospital admissions for ocular bone fractures also fell significantly statewide, as did intracranial injuries in Greater Brisbane. These are some of the most common fractures related to alcohol.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=435&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=435&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=435&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=547&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=547&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286898/original/file-20190805-36372-17kv83r.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=547&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 5. Monthly count of intracranial injury hospital admissions among 16-to-65-year-olds, Brisbane.</span>
<span class="attribution"><a class="source" href="https://static1.squarespace.com/static/578598c7e4fcb510ac255c7c/t/5d3e38c75339530001bac928/1564358863617/QUANTEM+Final+report+-+Summary_2Apr19.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Hospital admissions for alcohol intoxication and a range of injuries, which had been increasing, also levelled out statewide and in Brisbane.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=438&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=438&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=438&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=550&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=550&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286897/original/file-20190805-36353-fijzae.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=550&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 6. Monthly rate of alcohol intoxication hospital admissions among 16-to-65-year-olds per 10,000 population, Queensland.</span>
<span class="attribution"><a class="source" href="https://static1.squarespace.com/static/578598c7e4fcb510ac255c7c/t/5d3e38c75339530001bac928/1564358863617/QUANTEM+Final+report+-+Summary_2Apr19.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fewer-alcohol-related-visits-to-inner-sydney-emergency-room-since-lockout-laws-introduced-92343">Fewer alcohol-related visits to inner Sydney emergency room since 'lockout laws' introduced</a>
</strong>
</em>
</p>
<hr>
<p>Other key findings included:</p>
<ul>
<li><p>no displacement of issues to outside safe night precincts for most of the state</p></li>
<li><p>at least one serious crime solved (such as rape and grievous bodily harm) per week using ID scanner data.</p></li>
</ul>
<p><strong>DRINKING CULTURE</strong></p>
<p>Key findings included:</p>
<ul>
<li>the proportion of patrons in safe night precincts reporting pre-drinking remains high and has not changed</li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/queenslanders-are-among-our-heaviest-drinkers-on-nights-out-and-changing-that-culture-is-a-challenge-121115">Queenslanders are among our heaviest drinkers on nights out, and changing that culture is a challenge</a>
</strong>
</em>
</p>
<hr>
<ul>
<li>education/awareness campaigns were ineffective at reducing intoxication and violence.</li>
</ul>
<p><strong>BUSINESS IMPACTS</strong></p>
<p>The economic evaluation identified a A$16 million overall benefit from the changes to the Queensland community. The returns on every dollar spent by govt on implementation have been A$1.96-6.80. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=141&fit=crop&dpr=1 600w, https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=141&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=141&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=177&fit=crop&dpr=1 754w, https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=177&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/287122/original/file-20190807-84210-p1kig6.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=177&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Table 2. Benefit, cost, net present value (NPV) and benefit-cost ratio (BCR) sensitivity analysis using 50% of implementation cost to the government (in 2018 dollars)</span>
<span class="attribution"><a class="source" href="https://static1.squarespace.com/static/578598c7e4fcb510ac255c7c/t/5d3e38c75339530001bac928/1564358863617/QUANTEM+Final+report+-+Summary_2Apr19.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Other findings included:</p>
<ul>
<li><p>increased number of liquor licences across Queensland</p></li>
<li><p>increased number of people using transport (public transport, taxis and Uber) on weekend nights in Fortitude Valley over time</p></li>
<li><p>tourism continues to grow strongly statewide</p></li>
<li><p>all live music performances have continued to increase. However, the number of original live music performances may have continued declining since 2012.</p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/tighter-alcohol-licensing-hasnt-killed-live-music-but-its-harder-for-emerging-artists-121117">Tighter alcohol licensing hasn't killed live music, but it's harder for emerging artists</a>
</strong>
</em>
</p>
<hr>
<h2>Building on the gains</h2>
<p>The findings are terrific news in terms of reductions in ambulance callouts, serious assaults and hospital admissions, although alcohol-related harm across much of Queensland has remained stable. Further, the policy has not significantly harmed business and has delivered an overall economic benefit to the community. </p>
<p>The report made <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1076.pdf">recommendations</a> to further reduce alcohol-related harm. These include increasing banning periods for unruly patrons, shutting venues at 3.30am and introducing point-of-sale health promotion. </p>
<p>But, overall, the evaluation is a good news story for the people of Queensland. These findings hold important lessons for other states grappling with how to reduce alcohol-related violence.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/designer-nights-out-good-urban-planning-can-reduce-drunken-violence-52768">Designer nights out: good urban planning can reduce drunken violence</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/121114/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Central Australian Aboriginal Congress, Northern Territory government, Australian Rechabites Foundation, Northern Territory Primary Health Network, Lives Lived Well, Queensland government and Australian Drug Foundation, travel and related costs from Queensland Police Service, Queensland Office of Liquor Gaming and Racing and the Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm. </span></em></p><p class="fine-print"><em><span>Jason Ferris receives funding from from Australian Research Council and Australian National Health and Medical Research Council, grants from State (Tasmania, Victoria, Queensland) and Federal Governments, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, University of Queensland, National Institute of Health, Global Drug Survey. He is affiliated with the Global Drug Survey and the Queensland Mental Health Commission.</span></em></p><p class="fine-print"><em><span>Kerri Coomber receives funding from the Australian Research Council, Northern Territory Government, and Queensland Government.</span></em></p>A comprehensive two-year evaluation of statewide measures introduced in 2016 has shown it’s possible to reduce alcohol-related violence while also producing economic benefits.Peter Miller, Professor of Violence Prevention and Addiction Studies, Deakin UniversityJason Ferris, Associate Professor, Program Leader for Research and Statistical Support Service and Program Leader for Substance Use and Mental Health, Centre for Health Services Research, The University of QueenslandKerri Coomber, Research Fellow, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1189992019-07-21T20:01:25Z2019-07-21T20:01:25ZAll-night public transport hasn’t reduced alcohol-related harm in Melbourne<figure><img src="https://images.theconversation.com/files/284677/original/file-20190718-116569-1q1mizh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The clearest change following the introduction of 24-hour public transport was that people were observed to be getting more intoxicated.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-young-men-toasting-nightclub-777379603?src=K37ud_oBMvMSuNWsYP0Sbg-1-29&studio=1">bbernard/Shutterstock</a></span></figcaption></figure><p>The Victorian government introduced <a href="https://www.ptv.vic.gov.au/more/travelling-on-the-network/night-network">24-hour public transport on Friday and Saturday nights</a> in Melbourne from January 1 2016. Services mostly run every hour from 1am to 5am on all metropolitan lines with some additional tram and bus services. The initiative, originally labelled “<a href="https://www.google.com/url?q=https://www.premier.vic.gov.au/24-hour-public-transport-to-get-you-homesafe/&sa=D&ust=1563348635932000&usg=AFQjCNGoY3wP6Ei1WMh4b9p9yhgUpStpcg">Homesafe</a>”, was proposed as a convenient and safe way to travel in and out of the city throughout the night. But our research shows it did not reduce alcohol-related violence and road accidents. </p>
<p>The budgeted cost of the program is <a href="https://www.theage.com.au/national/victoria/allnight-public-transport-to-keep-running-in-melbourne-20170422-gvq5wn.html">almost A$300 million</a> through to 2020. This includes the cost of <a href="https://www.legalaid.vic.gov.au/find-legal-answers/public-transport-offences/protective-services-officers">protective services officers</a> whose sole role is to patrol train stations and associated areas, ensuring the safety of night-time public transport users.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-need-more-than-just-laws-to-ensure-responsible-alcohol-service-80890">We need more than just laws to ensure responsible alcohol service</a>
</strong>
</em>
</p>
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<h2>What did the research show?</h2>
<p>Our research evaluated the introduction of 24-hour public transport from two different perspectives. </p>
<p>For our <a href="https://www.ncbi.nlm.nih.gov/pubmed/30476877">first study</a>, we conducted covert observations of four nightclub venues in Melbourne in the year before and after 24-hour public transport was introduced. Patrons’ observed levels of intoxication inside venues increased after 24-hour public transport was introduced (see figures 1a-d).</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=439&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=439&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=439&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=552&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=552&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284646/original/file-20190718-147279-1vl5o9r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=552&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 1. Proportions of patrons: a) in venue by time of observation; b) showing intoxication signs; c) too intoxicated; d) showing signs of drug use.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Our <a href="https://www.jsad.com/doi/10.15288/jsad.2019.80.314">second study</a> used data on police assaults, alcohol- and drug-related ambulance attendances, road crashes from the areas serviced by public transport, Myki public transport card touch-ons, and pedestrian counts to determine the impact of 24-hour public transport on alcohol-related harms in the city. </p>
<p>Figure 2 shows an immediate increase in police-recorded assaults, until increased police resources were allocated. A temporary reduction followed, although more recent data from the Victorian Crime Statistics Agency (see table 1) show serious assaults have remained stable with a peak in 2018.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=409&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=409&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=409&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=514&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=514&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284647/original/file-20190718-147312-zbgl4c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=514&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 2. Number of police-recorded assaults resulting in arrest or summons in postcode 3000 during high-alcohol hours, 2015 and 2016.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=97&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=97&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=97&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=122&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=122&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284679/original/file-20190718-116596-1tjsvx5.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=122&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Table 1. Serious assaults recorded on a street/lane/footpath or licensed premises in postcodes 3000 and 3006 during high-alcohol hours, April 2015 to March 2019.</span>
<span class="attribution"><a class="source" href="https://www.crimestatistics.vic.gov.au/">Data: Victorian Crime Statistics Agency</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Road crashes in the areas serviced by public transport remained relatively stable from 2015 to 2016, as figure 3 shows.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=361&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=361&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=361&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=454&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=454&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284649/original/file-20190718-147275-1ckvmi7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=454&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 3. Average number of road crashes during high-alcohol hours, 2015 and 2016.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>There was little change in the number of people attending the central business district. Figure 4 shows pedestrian counts around Flinders Street Station throughout the night before and after 24-hour services began.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=357&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=357&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=357&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=448&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=448&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284674/original/file-20190718-116579-16d441l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=448&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Figure 4. Count of pedestrians by Flinders Street Station foot traffic counter during high-alcohol hours, 2015 and 2016, by day and hour.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>While correlation doesn’t necessarily equal causation, the measures clearly failed to achieve any substantial reduction of alcohol-related harms.</p>
<p>If the aim of the policy was to boost “Melbourne’s 24-hour lifestyle”, then it may be considered successful. More people were in the city later in the evening, using public transport and attending bars and clubs, resulting in higher levels of intoxication in these venues. This is clearly a massive win for the alcohol industry and others that profit from very late-night drinkers on the streets.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/factcheck-can-you-change-a-violent-drinking-culture-by-changing-how-people-drink-38426">FactCheck: can you change a violent drinking culture by changing how people drink?</a>
</strong>
</em>
</p>
<hr>
<p>These findings, which assess the effects of more than A$300 million in state expenditure, are also important when considering current reviews of liquor laws in Sydney and Queensland, where the alcohol industry and aligned interest groups are proposing 24-hour public transport.</p>
<h2>What else could be done?</h2>
<p>Other jurisdictions around the world have chosen a range of approaches to reduce alcohol-related harm. By far the most evidence-based policy option is to close venues earlier in the night. </p>
<p>Ending the serving of alcohol at 3am has been <a href="https://theconversation.com/early-pub-closing-times-work-for-kings-cross-they-will-for-queensland-too-39643">the most common variant of this policy in Australia</a>. Australian examples of this approach have been associated with substantial reductions in assaults – <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1360-0443.2010.03125.x">37% in Newcastle</a> and <a href="https://onlinelibrary.wiley.com/doi/10.1111/add.12951">39% in Sydney’s Kings Cross</a>.</p>
<p>In 2016, Queensland implemented similar restrictions as well as mandatory ID scanning. This means banned patrons are reliably detected before entering venues. Findings from a <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4811-9">two-year evaluation</a> are soon to be released.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/banning-orders-wont-solve-alcohol-fuelled-violence-but-they-can-be-part-of-the-solution-72091">Banning orders won't solve alcohol-fuelled violence – but they can be part of the solution</a>
</strong>
</em>
</p>
<hr>
<p>Another possibility is an adaptation of the violent venues scheme in New South Wales, which has seen <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/add.12951">sustained reductions across the state since 2008</a>.</p>
<p>Our findings suggest the money spent on 24-hour public transport is associated with increases in intoxication and violence. </p>
<p>Another consideration is that reducing taxi queues is no longer the issue it once was. The rise of Uber has provided much more flexibility in nightlife transport. </p>
<p>Governments should trial different policy options to determine what works for their jurisdiction. These trials should be <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4811-9">rigorously and independently evaluated</a>. Effective measures can then be identified, unintended consequences addressed and ineffective or overly costly measures replaced.</p><img src="https://counter.theconversation.com/content/118999/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Central Australian Aboriginal Congress, Northern Territory government, Australian Rechabites Foundation, Northern Territory Primary Health Network, Lives Lived Well, Queensland government and Australian Drug Foundation, travel and related costs from Queensland Police Service, Queensland Office of Liquor Gaming and Racing and the Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm. </span></em></p><p class="fine-print"><em><span>Ashlee Curtis does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A program aimed at getting people home safely has cost A$300 million but has had little impact, aside from increased intoxication in CBD venues. Rates of assaults and road crashes are much the same.Ashlee Curtis, Research Fellow, School of Psychology, Deakin UniversityPeter Miller, Professor of Violence Prevention and Addiction Studies, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1130812019-03-07T15:59:54Z2019-03-07T15:59:54ZHow alcohol companies are using International Women’s Day to sell more drinks to women<figure><img src="https://images.theconversation.com/files/262511/original/file-20190306-100793-1xde2om.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Three cheers!</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/female-friends-make-toast-they-celebrate-623150330">Monkey Business Images</a></span></figcaption></figure><p><a href="https://www.internationalwomensday.com">International Women’s Day</a> on March 8 celebrates women’s achievements across the world and calls for action to speed up gender equality. Many alcohol companies also see it as an ideal opportunity to market their products to women. Diageo, the world’s largest spirits business, is an <a href="https://www.internationalwomensday.com/Partners">official supporter</a> of this year’s international day. It has <a href="https://www.diageo.com/en/news-and-media/features/celebrating-international-women-s-day-2019-balanceforbetter/">launched</a> a series of tie-in videos, mainly of senior female staff talking about professional and personal challenges they face as women. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=883&fit=crop&dpr=1 600w, https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=883&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=883&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1109&fit=crop&dpr=1 754w, https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1109&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/262515/original/file-20190306-100784-10fro3i.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1109&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Spirit of the times.</span>
<span class="attribution"><span class="source">Diageo</span></span>
</figcaption>
</figure>
<p>Diageo’s Smirnoff brand is in the third year of an Equalising Music campaign to increase women’s representation in the music industry. Originally <a href="http://www.musicweek.com/brands/read/smirnoff-kicks-off-equalising-music-campaign-to-mark-international-women-s-day/067740">launched</a> to tie in with International Women’s Day, Smirnoff <a href="https://www.musicbusinessworldwide.com/uk-tastemaker-annie-mac-to-head-up-gender-equality-initiative-the-equalizing-music-pledge/">recently unveiled</a> BBC Radio One DJ Annie Mac to help spearhead the campaign. For this year’s international day, it is co-launching a new Spotify feature called <a href="http://www.pretty52.com/entertaining/music-smirnoff-partner-with-spotify-on-equalising-music-campaign-for-iwd-20180307">Smirnoff Equaliser</a> that enables users to see what percentage of female artists they have listened to in the last six months. </p>
<p>Elsewhere in the Diageo universe, don’t be surprised to see toasts of Jane Walker Scotch to celebrate female diversity. This <a href="https://www.just-drinks.com/news/diageos-the-jane-walker-by-johnnie-walker-to-back-womens-march_id127578.aspx">limited edition</a> version of Johnnie Walker black label, featuring a striding woman in a top hat and boots, was <a href="https://www.theguardian.com/business/2018/feb/26/jane-walker-black-label-whisky-celebrate-international-womens-day-diageo">originally launched</a> to coincide with last year’s International Women’s Day, “as another symbol of the brand’s commitment to progress”. For each bottle sold, the company donated US$1.00 (£0.76) to women’s organisations. </p>
<p>BrewDog, the Scottish-based brewer, has also used International Women’s Day as a marketing vehicle. Last year it <a href="https://www.bbc.co.uk/news/newsbeat-43300969">repackaged</a> its Punk IPA brand as Pink IPA “Beer for Girls” as part of a campaign to supposedly highlight the gender pay gap and sexist advertising. The company later <a href="https://www.morningadvertiser.co.uk/Article/2018/04/06/BrewDog-bosses-admit-regrets-over-Pink-IPA-stunt">expressed regret</a> after many people <a href="https://www.morningadvertiser.co.uk/Article/2018/03/06/BrewDog-faces-online-backlash-over-beer-for-girls">attacked</a> the branding for itself being sexist. Perhaps unsurprisingly, BrewDog has not opted for a re-run, <a href="https://www.vernonmorningstar.com/video/pentictons-cannery-brewing-celebrates-women-with-new-brew/">but</a> numerous <a href="https://www.canadianbeernews.com/2019/03/05/railway-city-brewing-releasing-fehr-game-irish-red-ale-for-international-womens-day/">other</a> brewers <a href="https://eu.greenvilleonline.com/story/life/2019/03/05/international-womens-day-special-birds-fly-south-greenville-south-carolina/3067888002/">have</a> launched <a href="https://www.citybeat.com/food-drink/whats-the-hops/blog/21048803/cincinnati-breweries-go-big-for-international-womens-day">commemorative</a> beers for this year’s International Women’s Day – in many cases emphasising the role of female brewers. </p>
<p><a href="https://www.gospotcheck.com/blog/how-male-driven-alcohol-brands-are-pivoting-to-target-women-more-effectively">Women are</a> an important market to the alcohol industry. In the UK, for example, while <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/add.13452">men still drink</a> significantly more than women, and suffer more harm as result, the gap has shrunk dramatically. Men born in the early 1900s <a href="https://bmjopen.bmj.com/content/6/10/e011827?utm_content=consumer&utm_medium=cpc&utm_source=trendmd&utm_term=1-A&utm_campaign=bmjo">were</a> 2.2 times more likely than women to drink alcohol; three times more likely to drink in a way that suggested problematic use; and 3.6 times more likely to experience alcohol-related harms. </p>
<p>Men born in the late 1990s, on the other hand, are only 1.1 times more likely to drink, 1.2 times more likely to drink problematically and 1.3 times more likely to experience alcohol-related harms. Many marketers will probably see the remaining gap as proof of growth potential in women’s drinking. </p>
<h2>The pitch</h2>
<p>To appeal to women, alcohol companies have gradually developed different drinks, which <a href="http://eucam.info/wp-content/uploads/2014/05/women_the_new_market_final.pdf">tend to be</a> sweet, pink, fruit flavoured or low calorie. Their marketing strategies evolved as well. Where alcohol marketers used to regularly sexualise and objectify women to sell alcohol to men, they now often align brands with fun, sophistication, female friendship and empowerment. Baileys, for example, targets millennial girls – and their mothers – with its “<a href="http://baileys.tumblr.com">Here’s To Us</a>” campaign. This <a href="https://www.thedrum.com/news/2014/11/20/baileys-targets-millennial-women-new-global-ad-campaign">celebrates</a> the “power of female friendship” and encourages women to get together and toast one another. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/3VCC3VL5SCM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>According to research I co-authored, there is a clear link between alcohol and our gendered identity: both <a href="https://www.sciencedirect.com/science/article/pii/S0955395918301117?via%3Dihub">younger</a> and <a href="https://www.sciencedirect.com/science/article/pii/S0955395914003624?via%3Dihub">older</a> women show people who they are by what they drink and how they drink it. The alcohol industry is <a href="https://www.bmj.com/content/340/bmj.b5650">well aware</a> of this and exploits it fully in its advertising. </p>
<p>The industry’s pitch to women’s empowerment is <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/add.12832">particularly strong</a> in poorer countries, which are often less regulated and have lower advertising costs. For example, Diageo <a href="https://www.eabl.com/en/our-brands/spirits/snapp">markets</a> a fruit-flavoured alcohol drink called Snapp at women in parts of Africa. According to the strapline, “Snapp celebrates today’s woman: she is empowered, confident and stylish.” </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=797&fit=crop&dpr=1 600w, https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=797&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=797&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1002&fit=crop&dpr=1 754w, https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1002&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/262517/original/file-20190306-100781-fnsuwe.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1002&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Mmmm liberation.</span>
</figcaption>
</figure>
<p>Researchers have <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/add.12832">argued that</a> this doesn’t only seek to attract female customers, but also to influence how alcohol is perceived by local women’s networks who might otherwise see female drinkers as distasteful. This echoes tobacco marketing campaigns over the years: a good example is Virginia Slim’s “You’ve Come a Long Way Baby” <a href="https://flashbak.com/youve-come-a-long-way-baby-virginia-slims-advertising-year-by-year-365664/">campaign</a> in the late 1960s, which linked the product to women’s liberation. </p>
<p>The tension in whether alcohol marketing has women’s interests at heart is possibly most pronounced around “<a href="https://iogt.org/news/2015/09/15/study-pinkwashed-alcohol-products-promotions-exposed/">pinkwashing</a>”, where companies engage in breast cancer awareness activities like the pink ribbon campaign while selling products that are <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-cancer/does-alcohol-cause-cancer">known to be</a> carcinogenic. For example, some Californian wine producers <a href="https://www.mercurynews.com/2017/10/03/5-great-wines-that-support-breast-cancer-awareness-and-research/">give money</a> to breast cancer charities for every bottle of wine sold, fund clinical trials for women with breast cancer or pay for mammograms. </p>
<p>A <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/add.13035">study from 2015</a> emphasised that alcohol is responsible for an estimated 8% of breast cancers worldwide. It raised concerns that pinkwashing “contributes to risk in the name of prevention” and “extends the marketing reach with links to charitable causes and access to young women, many of whom may already drink at risky levels”. </p>
<h2>Brand bandits</h2>
<p>Alcohol brands <a href="https://twitter.com/hashtag/boozecalendar">piggyback</a> on every notable date in the calendar, including <a href="https://www.gettingpersonal.co.uk/mothers-day-gifts/personalised-alcohol-for-mothers-day.htm">Mother’s Day</a>, <a href="https://www.marieclaire.co.uk/life/food-drink/asda-pink-valentines-day-gin-642717">Valentine’s Day</a> and even <a href="https://www.beerwulf.com/en-gb/articles-about-craft-beer/beer-pancakes/">Pancake Day</a>. On one level, International Women’s Day is just another of these marketing opportunities to normalise alcohol consumption. Yet linking alcohol brands with empowerment is particularly troubling, given that alcohol is a <a href="https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)31310-2.pdf">leading global risk factor</a> for early death among women aged 15-49 years. In the UK, alcohol-specific death rates <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/alcoholrelateddeathsintheunitedkingdom/registeredin2017">increased</a> 21% for women between 2001 and 2017. </p>
<p>This year’s <a href="https://www.internationalwomensday.com/Theme">theme</a> for International Women’s Day is #BalanceforBetter, a call to build a more gender-balanced world. To achieve this, the campaign suggests challenging stereotypes and raising awareness. In Scotland, where I am based, we have been running a social media campaign with Alcohol Focus Scotland <a href="https://alcoholcampaign.org/2018/11/27/dontpinkmydrink/">#dontpinkmydrink</a>, to identify and expose examples of cynical alcohol marketing. When it comes to achieving true equality for women, raising rates of alcohol-related diseases and death rates to the same levels as men is one type of progress that we could really do without. </p>
<p>A Diageo spokesperson said: “Diageo’s celebration of International Women’s Day is linked to the strong focus we put on inclusion and diversity as a business. Forty percent of Diageo’s executive committee are women; we’ve been ranked the fourth most diverse and inclusive business in the world by Thomson Reuters; are listed in the Bloomberg Gender Equality Index; and have been ranked as the best company in the UK for gender equality by Equileap. Our communications activity is focused on celebrating the women and men throughout our business, with the primary objective of engaging potential future employees.”</p><img src="https://counter.theconversation.com/content/113081/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Carol Emslie has received funding for research from NIHR, Cancer Research UK, Scottish Health Action on Alcohol Problems and the Medical Research Council. She is on the Grants Advisory Panel for Alcohol Research UK. Carol consulted Alison Douglas of Alcohol Focus Scotland in putting this article together. </span></em></p>Alcohol is a leading cause of early deaths among 15- to 49-year-old women worldwide, but drinks marketers love using empowerment to sell them more products.Carol Emslie, Professor / Lead Substance use & misuse research group, Glasgow Caledonian UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/607252016-06-27T14:42:31Z2016-06-27T14:42:31ZDoes drink really make you happy?<figure><img src="https://images.theconversation.com/files/128293/original/image-20160627-28373-wlhmuz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Binge_drinking#/media/File:William_Hogarth_-_A_Midnight_Modern_Conversation.jpg">William Hogarth/Yale Center for British Art</a></span></figcaption></figure><p>For those of us that partake, drinking alcohol is often seen as a balancing act that weighs up the pleasures of drinking against the pains. Government regulation is often seen the same way, weighing the benefits of pleasure and freedom of the individual on one hand against the cost of crime and health harms on the other. Yet while such simplicity has its charms, it might actually lead to bad alcohol policies that don’t achieve the best balance between pleasure and pain.</p>
<p>For example, in the eyes of some – including simplistic versions of cost-benefit models used by some governments - every time you have a drink you make a fully rational decision to <a href="http://www.investopedia.com/terms/t/totalutility.asp">maximise your own utility</a>. This ignores issues of alcohol addiction and the fact that it’s quite a stretch to describe yourself as “fully rational” at 2am after ten pints when a friend has just suggested a round of tequila. But because pleasure is not generally something that alcohol researchers examine, the alcohol debate is dominated by either these naive models or optimistic assertions by lobbyists about alcohol’s happiness-inducing effects.</p>
<p>In a new paper published in <a href="http://www.benbaumberg.com/files/2016%20SSM%20post-print%20%20-%20alcohol%20policy%20and%20wellbeing%20paper.docx">Social Science and Medicine</a>, <a href="http://www.sussex.ac.uk/profiles/302100">George MacKerron</a> and I examined what evidence there was to tease out the relationship between alcohol and happiness. To try to capture some of the complexities, we took two approaches:</p>
<p>One study collected data from iPhone users through the <a href="http://www.mappiness.org.uk/">Mappiness app</a> app George created, which buzzed people a couple of times a day to ask how happy they were, what they were doing, and who they were doing it with. This is a huge study, with over 2m observations from more than 30,000 people.</p>
<p>The other study was more traditional, using the <a href="http://www.cls.ioe.ac.uk/page.aspx?&sitesectionid=795&sitesectiontitle=Welcome+to+the+1970+British+Cohort+Study">1970 British Cohort Study</a> to see how the cohort’s members’ alcohol consumption changed between the ages of 30, 34 and 42, and what links we can see between changes in their life satisfaction and their drinking.</p>
<p>What we found is that alcohol does make you happier in the moment, by about three to four points on a zero to 100 scale. These models look at changes within individuals over time, and ignore differences between different sorts of people. There’s also no sign of a hangover effect on happiness, although people tend to be less awake the morning after drinking.</p>
<p>But there are several substantial caveats to this evidence of a pleasurable effect. There is a relatively small overspill of happiness into moments when people are not drinking (a difference of less than 0.5 points on a zero to 100 scale between those weeks or months in which people drink more versus less often). What’s more, looking at year-to-year changes, people are no more satisfied with life in heavier-drinking years than in lighter-drinking years. Indeed, if they develop a drink problem, then they become noticeably less satisfied with life (by about 0.2 points on a zero to ten scale). </p>
<p>These are the effects on average, and there is good reason to think that different patterns of drinking in different settings will have different effects on different types of people. The iPhone users in the Mappiness study, for example, are much younger and richer than average, and we only know whether people are drinking, not the amount they drink or indeed what they’re drinking. Anecdotally, most of us can think of drinks that we particularly enjoyed, and others that, in retrospect (or even at the time), made us less happy.</p>
<p>To return to alcohol policies, these findings challenge the naive assumption that all drinking makes us more happy in every way, and prompts us to think more carefully about what we might mean by “pleasure” or “happiness” in this context. Instead, it should make us consider whether there are possible policies that could help us cut down only the drinks that don’t make us happy. It might even be the case that – <a href="https://ideas.repec.org/a/bpj/bejeap/vadvances.5y2005i1n4.html">as found for cigarette taxes</a> – certain regulation may make us happier as well as healthier than we were before.</p>
<p>Most of all, we need to stop reducing the whole spectrum of human pleasure to naive economic models or the vested interests of governments, companies or lobby groups, and actually think about how much we value different aspects of pleasure and enjoyment – including how we drink alcohol – and which policies best balance alcohol’s pleasures against its harms.</p><img src="https://counter.theconversation.com/content/60725/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ben Baumberg Geiger has received funding from the Medical Research Council and Economic and Social Research Council (related to this work), and from the European Commission and World Health Organization for other projects. He previously worked at the Institute of Alcohol Studies,
(IAS), which is primarily funded by the Alliance House Foundation (formerly the UK
Temperance Alliance); further detail can be found from <a href="http://www.ias.org.uk/Who-we-are.aspx">http://www.ias.org.uk/Who-we-are.aspx</a>. He is also a member of the Labour Party, Compass, and the Fabian Society, and has previously worked on secondment at the Department of Work and Pensions (under the present Government). BBG is writing in a personal and non party-political capacity, and the views expressed in this article should not be interpreted as the official position of any of the above organisations.</span></em></p>Mere economic models don’t take into account the full complexity of our relationship with alcohol.Ben Baumberg Geiger, Senior Lecturer in Sociology and Social Policy, University of KentLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/436782015-06-24T13:52:51Z2015-06-24T13:52:51ZWhat happens to those left behind by a drug or alcohol-related death?<figure><img src="https://images.theconversation.com/files/86247/original/image-20150624-31526-6yeysj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Left alone</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The people left behind when someone close to them dies from drug or alcohol use are often forgotten about, especially when it comes to research. Yet the numbers of those affected by these deaths are far from insignificant.</p>
<p>There were well over <a href="http://www.ons.gov.uk/ons/taxonomy/index.html?nscl=Alcohol-related+Deaths">8,000 alcohol-related</a> and <a href="http://www.ons.gov.uk/ons/taxonomy/index.html?nscl=Drug-related+Deaths">4,000 drug-related deaths</a> registered in England and Wales in 2012. And the actual numbers are likely to be far higher than suggested by official statistics because some deaths are not recorded or categorised as being alcohol or drug-related.</p>
<p>Such deaths are frequently featured in the press, especially those of young people and celebrities. But they are often reported in a way that distances the reader rather than inviting sympathy for grieving family members. One bereaved father interviewed for our research on this topic, reflecting on news coverage of his son’s death, said:</p>
<blockquote>
<p>I just read ‘Unemployed man dies of drug overdose’ and read down through and it was [my son] and I don’t think the main point about him was that he was unemployed. There was more to [him] than an unemployed man.</p>
</blockquote>
<p>Indeed, those left behind are more likely to be pathologised and stigmatised as part of the problem. One bereaved mother who tried to get help with her son’s problem drinking said: </p>
<blockquote>
<p>It would seem that they immediately went down the route of what’s going on in the family? …this is a family that aren’t functioning well together.</p>
</blockquote>
<p>As such, the bereaved families of drug or alcohol-related deaths remain a hidden and neglected group, with profound consequences for their own health and well-being.</p>
<h2>Poor treatment</h2>
<p>One consequence of this stigma is the frequently poor and insensitive treatment these bereaved people may receive at the hands of the professionals dealing with this kind of death. This can include those working for the NHS, police and legal authorities, funeral services and drug and alcohol treatment and bereavement services.</p>
<p>This was the situation we found during <a href="http://www.bath.ac.uk/cdas/research/understanding-those-bereaved-through-substance-misuse/">a study</a> by the universities of Bath and Stirling involving lengthy interviews with 106 family members bereaved in this way. Finding such a relatively large sample is perhaps evidence of just how much it has meant to this group of bereaved people to have the chance to tell their stories. Some participants reported being treated with empathy and respect. But more often they met with responses that reinforced the sense that their loss was considered less important than that associated with other types of death. </p>
<p>One bereaved mother talking about the death of her son reported people’s negative reaction thus:</p>
<blockquote>
<p>'He was on drugs, what do you expect?’ That was the impression you got. That was the truth of what they were thinking. Whether they were saying ‘so and so’ to me, they are saying to themselves: ‘Another one bites the dust.’ </p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/86248/original/image-20150624-31498-k7wkoh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/86248/original/image-20150624-31498-k7wkoh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/86248/original/image-20150624-31498-k7wkoh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/86248/original/image-20150624-31498-k7wkoh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/86248/original/image-20150624-31498-k7wkoh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/86248/original/image-20150624-31498-k7wkoh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/86248/original/image-20150624-31498-k7wkoh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Dealing with grief.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Such treatment is all the more distressing for the bereaved person when they have to negotiate an unfamiliar, complex, confusing and time-consuming process involving a range of separate organisations, often with little or no guidance. Indeed, as we discovered in focus groups with 40 practitioners representing the range of services involved, there is little in the way of any coherent national or local strategy in how organisations respond.</p>
<p>Instead we found that practitioners are also up against the system. Poor responses in part reflect the disparate working practices and cultures between organisations, in which practitioners inevitably lose sight of the bigger picture. The main concern of the front-line services involved in the most immediate aftermath of the death, such as the police, is with the deceased and establishing the cause of death, rather than with the grief of those left behind.</p>
<p>However, we have also been fortunate enough to be able to work with these practitioners to make real inroads into improving the way those bereaved through substance use are treated. A working group of 12 mainly front-line practitioners took on the task of developing a set of best-practice guidelines for those whose work brings them into contact with these bereaved people.</p>
<h1>New guidelines</h1>
<p>Written by practitioners for practitioners, these guidelines directly engage the reader and invite empathy for the bereaved by explaining their predicament. They are built around <a href="http://www.bath.ac.uk/research/news/2015/06/23/bereavement-guidelines/">five key messages</a> from the interview data, which reflected what the bereaved family members said they needed. These messages are that every practitioner must remember: to show kindness and compassion; that language is important; that every bereaved person is an individual; that everyone can make a contribution; and to work together.</p>
<p>In practice, we hope these principles will encourage practitioners to take actions that will improve the way they work with the bereaved. This can range from simple things like referring to their “son” or “wife” rather than “the deceased”, to carrying out careful planning with the bereaved person of the time they will work with them. We have also provided guidance for practitioners on dealing with specific situations, such as acknowledging a bereaved person’s anger or criticisms towards an organisation and seeking support if the practitioners themselves feel guilty.</p>
<p>By encouraging practitioners to prioritise the human element of their work, the guidelines will promote a culture shift in the way these bereaved people are treated. This can counter rather than reinforce social stigma, reducing their stress and supporting their well being.</p><img src="https://counter.theconversation.com/content/43678/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christine Valentine receives funding from ESRC.</span></em></p>New research aims to bring hope to the often forgotten or stigmatised friends and relatives of those who die from drug or alcohol use.Christine Valentine, Research associate in sociology, University of BathLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/396432015-04-09T04:40:55Z2015-04-09T04:40:55ZEarly pub closing times work for Kings Cross – they will for Queensland too<figure><img src="https://images.theconversation.com/files/77434/original/image-20150409-15240-10k8trn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Early closing times reduce alcohol-fuelled violence but still face opposition from businesses</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/brunogirin/70449421">Bruno Girin/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>The newly elected <a href="http://www.brisbanetimes.com.au/queensland/lockouts-and-3am-closing-time-served-up-20150326-1m8rwn.html">Queensland government has said it will push ahead</a> with its plan to introduce lockouts and 3am closing times for pubs and clubs. Despite objections from vested interests, there’s now plenty of evidence to show this is a good idea for patrons and businesses alike.</p>
<p>Just 12 months after they were introduced, early closing times for pubs and clubs in central Sydney have caused a massive decline in crime throughout the previously violence-ridden Sydney suburb of Kings Cross. NSW Police data <a href="http://www.dailytelegraph.com.au/news/opinion/cross-clean-up-is-a-victory-for-sydney/story-fni0cwl5-1227286782205">reported in Sydney’s Daily Telegraph</a> last week illustrates the impact of trading hours restrictions in King Cross after 12 months. It shows:</p>
<ul>
<li>sexual assaults in the area are down by 20.8%</li>
<li>assaults causing grievous bodily harm are down by 43%</li>
<li>assaults causing actual bodily harm have declined by 50.3%</li>
<li>robberies have fallen by a huge 57.1%</li>
<li>car theft is down by 44.6%, and </li>
<li>stealing from motor vehicles is down by 47.5%.</li>
</ul>
<p>Probably the most important gain – and one that’s not mentioned above – is the one <a href="http://www.dailytelegraph.com.au/news/opinion/cross-clean-up-is-a-victory-for-sydney/story-fni0cwl5-1227286782205">highlighted by Kings Cross local area commander</a> Superintendent Mick Fitzgerald: </p>
<blockquote>
<p>The man hours saved and the way we are able to reallocate our resources has been phenomenal.</p>
</blockquote>
<p>Many state governments in Australia expend massive resources on extra policing to effectively subsidise late-night venues by facilitating people drinking between 3am and 7am (despite the fact that <a href="http://www.fare.org.au/wp-content/uploads/2011/07/FARE-Alcohol-Poll-2014_LR.pdf">around 80% of the population</a> want pubs shut at 3am). But police in Kings Cross are now able to use their time dealing with criminal activity.</p>
<h2>Compelling arguments</h2>
<p>The state of Kings Cross a year on provides clear support for the newly elected <a href="http://www.brisbanetimes.com.au/queensland/lockouts-and-3am-closing-time-served-up-20150326-1m8rwn.html">Queensland government’s proposal</a> but, not unexpectedly, industry groups are critical of the idea. They argue “<a href="http://www.brisbanetimes.com.au/queensland/lockouts-and-3am-closing-time-served-up-20150326-1m8rwn.html">anti-social behaviour is a cultural problem, not an operational one</a>” and that the proposal will have a negative impact on the economy as well as worsening “<a href="http://www.brisbanetimes.com.au/queensland/lockouts-and-3am-closing-time-served-up-20150326-1m8rwn.html">law and order issues surrounding entertainment zones</a>”. </p>
<p>The experience of Kings Cross has already proven them wrong about the latter point. And the seven years since similar measures were introduced in Newcastle provide the other nails in the coffin of that argument. </p>
<p>The story from Newcastle is that you can change drinking culture and <a href="http://www.ndlerf.gov.au/publications/monographs/monograph-43">businesses don’t have to suffer</a>. There are now <a href="olgr.nsw.gov.au">almost 50% more liquor licences</a> in Newcastle than there were in 2008 when the original 3am close was put in place. And the new venues are mostly small bars and restaurants.</p>
<p>In research my colleagues and I did to explore what measures were effective for reducing alcohol-related harm, we compared Newcastle, with its blanket 3am closing time, to Geelong, where pubs could stay open until 7am. <a href="http://dro.deakin.edu.au/view/DU:30062340">We found</a> people were actually spending more money, on average, in Newcastle. </p>
<p>Venue operators in Newcastle didn’t mind going home earlier, particularly once they adapted their business models to focus on alternative forms of entertainment and especially providing meals. These venues are now thriving and have very low levels of <a href="http://www.ncbi.nlm.nih.gov/pubmed/24589092">alcohol-related assaults</a> and <a href="http://www.ncbi.nlm.nih.gov/pubmed/24612319">emergency department attendances</a>.</p>
<p>While we don’t have Australian data on how much money changes hands in the night-time economy, <a href="http://lordmayors.org/site/wp-content/uploads/2015/02/PN041230_TheAustralianNTE_vFinal.pdf">UK studies show</a> only 20% of sales made between 6pm and 6am occur after midnight. When you consider how busy most pubs are between midnight and 2am, it seems unlikely that closing times at 3am, when crowds have dwindled, will have a significant impact on business bottom lines.</p>
<h2>A better culture</h2>
<p>Many licensees in Newcastle were ultimately <a href="http://www.deakin.edu.au/dante">glad to have legislation put into place</a>, because previously there was always a rogue or desperate trader who wanted to open later. The legislation meant everyone was competing on a level playing field. </p>
<p>According to my count in Geelong, where no restrictions are in place, 19 licensed businesses have gone broke in the past six years. </p>
<p>While elements of the alcohol industry oppose earlier closing, they don’t provide any evidence to support their arguments. If they considered the benefits this will bring to individual businesses, they would support closing pubs earlier and begin planning to build their businesses on a different drinking culture – a culture that encourages people to go out earlier, eat more and pre-load less, rather than one that’s all about fuelling drunken patrons to dangerous levels.</p>
<p>The evidence overwhelmingly supports the Queensland government’s proposed state-wide reduction of hours when alcohol is sold. The results of early closing times in Kings Cross and Newcastle show the objections of self-interested minorities are baseless, especially when considering the huge economic and social benefits seen elsewhere.</p><img src="https://counter.theconversation.com/content/39643/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Disclosure statement
Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Queensland government and Australian Drug Foundation, travel and related costs from Australasian Drug Strategy Conference. He is affiliated with academic journal Addiction. He has acted as a paid expert witness on behalf of a licensed venue and a security firm.</span></em></p>The Queensland government has said it will push ahead with its plan to introduce lockouts and 3am closing times for pubs and clubs. This is a good idea for patrons and businesses alike.Peter Miller, Principal Research Fellow, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/384262015-03-10T03:33:06Z2015-03-10T03:33:06ZFactCheck: can you change a violent drinking culture by changing how people drink?<blockquote>
<p>You can’t change a culture by simply changing drinking. It is, of course, justifiable to explore the effectiveness of small measures such as advertising restrictions, increases or decreases in price, relaxation or restriction of hours, but such things tinker at the margins of culture and it is doubtful that they will alter the culture of violence and anti-social behaviour in any meaningful way. – Dr Anne Fox, author of a <a href="http://www.lionco.com/content/u12/Dr%20Anne%20Fox%20report.pdf">report</a> released by the Lion alcohol company, January 2015.</p>
</blockquote>
<p>The Lion alcohol company recently released a <a href="http://www.lionco.com/content/u12/Dr%20Anne%20Fox%20report.pdf">report</a> on Australian and New Zealand nightlife and violence. The study was conducted by an English anthropologist, Dr Anne Fox, working with a private research company.</p>
<p>In this report, the author visited towns in Australia and New Zealand and reviewed the literature on various drinking cultures. Dr Fox concludes that you can’t change a culture by simply changing drinking patterns.</p>
<p>There is a fair bit of opinion involved in determining the role that “culture” plays in alcohol-fuelled violence. </p>
<p>Dr Fox says we should be focusing on violence, misogyny, and aggressive masculinity. These things play a role, though they are usually poorly defined and require more sophisticated <a href="http://www.ncbi.nlm.nih.gov/pubmed/24428187">research</a>.</p>
<p>However, the evidence shows that we <em>can</em> make a meaningful difference to curbing a culture of violence and anti-social behaviour by changing drinking patterns.</p>
<p>In fact, there is a massive body of independent research that demonstrates a lack of impact from so-called “culture change” interventions such as <a href="http://www.cochrane.org/CD006748/ADDICTN_social-norms-interventions-are-not-effective-enough-to-reduce-alcohol-misuse-among-university-or-college-students">social norms campaigns</a>, generic <a href="http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780199551149.001.0001/acprof-9780199551149">education</a> in schools and occasional mass media campaigns warning of alcohol-related harm.</p>
<p>What the available evidence does show is that many assaults and hospital attendances that can be prevented by simple measures that alter drinking patterns, such as shutting licensed venues a few hours earlier. These measures cost the community very little compared to the vast expenditure on police and emergency services across Australia.</p>
<h2>Global data</h2>
<p>A rigorous body of experimental and observational evidence from around the world provides important insights into the real relationship between alcohol to violence, including that:</p>
<ul>
<li>If you shut the pubs and clubs in town two hours earlier, you see a <a href="http://www.ncbi.nlm.nih.gov/pubmed/20840191">30% to 40% reduction</a> in the number of assaults reported to police and the <a href="http://www.ncbi.nlm.nih.gov/pubmed/24612319">injuries turning up at emergency in hospital</a>.</li>
<li>If you stop repeat drink drivers from drinking, there is a <a href="http://www.ncbi.nlm.nih.gov/pubmed/23153129">10% reduction</a> in domestic violence cases reported to police state-wide.</li>
<li>People who receive alcohol are <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.486.6496&rep=rep1&type=pdf">more aggressive</a> than those who receive no alcohol or placebo beverages.</li>
<li>Intoxicated subjects <a href="http://link.springer.com/article/10.1007%2FBF00994162">are more likely</a> to administer electric shocks to others when provoked - and when they do shock others, they select a higher voltage.</li>
<li>Alcohol administration to men <a href="http://www.ncbi.nlm.nih.gov/pubmed/9830248">increases</a> the level of negative verbal behaviour displayed by the men and their partners. </li>
<li>Normally non-violent individuals can become violent <a href="http://www.ncbi.nlm.nih.gov/pubmed/10463811">when consuming a substantial amount of alcohol</a>. </li>
<li>Heavier consumption of alcohol results in <a href="http://www.ncbi.nlm.nih.gov/pubmed/12436812">conflict situations turning violent</a> between partners. </li>
<li>Alcohol use is more common among <a href="http://www.ncbi.nlm.nih.gov/pubmed/9122504">serious</a> physical assault <a href="http://link.springer.com/article/10.1023%2FA%3A1007522721430">events</a>.</li>
<li>Consumption of six or more drinks <a href="http://www.ncbi.nlm.nih.gov/pubmed/12602424">predicts</a> violent events in the family setting.</li>
<li>Blood alcohol content (BAC) of 0.19 was <a href="http://www.ncbi.nlm.nih.gov/pubmed/9830248">reported</a> in violent events compared to an estimated BAC of 0.11 in conflict events that did not include violence. </li>
<li>Treatment for alcohol dependence is associated with <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215582/">reductions</a> in <a href="http://www.ncbi.nlm.nih.gov/pubmed/12602429">intimate partner</a> violence, and this reduction is <a href="http://www.ncbi.nlm.nih.gov/pubmed/7751486">observable</a> up to two years post-treatment.</li>
</ul>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/12380856">For every hour</a> after midnight that pubs are open, there is a 15% to 20% increase in violence, drink driving <a href="http://www.ncbi.nlm.nih.gov/pubmed/24612319">and</a> emergency department attendances. Shutting pubs at 3:30am in Newcastle, NSW, rather than 5am, resulted in a <a href="http://www.ncbi.nlm.nih.gov/pubmed/20840191">37% decrease</a> in assaults. Paradoxically, there has been a <a href="http://www.ndlerf.gov.au/publications/monographs/monograph-46">25% increase</a> in liquor licences in Newcastle and people simply go out earlier and even spend more. </p>
<p>So we do know that straightforward measures such as shutting pubs earlier are <a href="http://www.ndlerf.gov.au/publications/monographs/monograph-43">meaningful</a> in the Australian context, but are extremely unpopular with industry. And across Australia there has been little action from political parties that <a href="http://www.fare.org.au/wp-content/uploads/2015/01/Alcohol-Industry-Donations-to-Queensland-Political-Parties-20-January-2015-FINAL.pdf">receive</a> industry <a href="http://www.fare.org.au/wp-content/uploads/2011/07/Alcohol-Industry-Donations-to-Political-Parties-25-November-FINAL.pdf">donations</a>.</p>
<h2>How does alcohol increase the likelihood of violence?</h2>
<p>Dr Fox makes anecdotal comparisons between countries such as Iceland, Spain and Italy. But put simply, Australia is not Italy. In Italy, when people drink, they drink <a>less</a> on any single drinking occasion than the <a href="http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter756Oct+2010#bingedrinking">average</a> Australian. Dr Fox even relates a personal <a href="http://www.abc.net.au/news/2015-02-27/macho-culture-to-blame-for-alcohol-fuelled-violence-dr-anne-fox/6270072">account</a> about how, one night when she was at a bar, some young men started to get rowdy and the bartender gave them whiskey to calm them down.</p>
<p>This might make an engaging story but it falls well short of scientific evidence. We don’t know what happened to the young men later that night when they met on the street outside or when they got home. Real violence often happens in the blink of an eye.</p>
<p>It is well-documented what happens to humans when they drink alcohol: reduced cognitive ability, disinhibition, inability to think of consequences, poor interpretation of social cues and obsessional thinking about single details.</p>
<p>These effects have been found in many studies and are <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2005.00994.x/abstract">reliably replicated</a> across many cultures. </p>
<p>Research from around the world has <a href="http://www.who.int/violence_injury_prevention/violence/world_report/factsheets/pb_violencealcohol.pdf">shown</a> that people are much more likely to be victims of alcohol-related violence when they are heavily intoxicated.</p>
<p>This is why we have responsible service of alcohol laws. When people are drunk, they make poor decisions, especially the decision to keep drinking.</p>
<h2>Verdict</h2>
<p>It’s not correct to say you can’t “alter the culture of violence and anti-social behaviour in any meaningful way” by tackling the way people drink. There is a lot of evidence showing that changing people’s drinking hours and consumption patterns reduces violence and hospital admissions – which is a lot more significant than tinkering at the margins of culture.</p>
<hr>
<h2>Review</h2>
<p>This review is a fair assessment of the question as to whether achieving cultural change is more effective than reducing alcohol related violence by curbing alcohol consumption. </p>
<p>As the reviewer rightly concludes, the evidence that measures to reduce consumption are effective is coherent and persuasive, while arguments to the contrary – including those put forward by Dr Fox – generally rely more on anecdote and intuition than empirical research.</p>
<p>Attempts to change Australia’s drinking culture using education campaigns have a poor record. At best, a small and temporary improvement is reported from some evaluations, while others show no change or even worse outcomes. The drinks industry is capable of spending many, many times more on continual and positive advertising than what governments can afford to spend on intermittent cautionary campaigns. This is not, and never has been, a level playing field. </p>
<p>The evidence is slowly accumulating for some control of alcohol advertising, marketing and promotion, as the current self-regulatory system is widely recognised to be worse than a joke. But no one should underestimate the political difficulties of achieving this. – <strong>Alex Wodak</strong></p>
<hr>
<p><div class="callout"> Have you ever seen a “fact” that doesn’t look quite right? The Conversation’s FactCheck asks academic experts to test claims and see how true they are. We then ask a second academic to review an anonymous copy of the article. You can request a check at checkit@theconversation.edu.au. Please include the statement you would like us to check, the date it was made, and a link if possible.</div></p><img src="https://counter.theconversation.com/content/38426/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Queensland government and Australian Drug Foundation, travel and related costs from Australasian Drug Strategy Conference. He is affiliated with academic journal Addiction.</span></em></p><p class="fine-print"><em><span>Alex Wodak is president of the Australian Drug Law Reform Foundation.</span></em></p>There is a lot of evidence showing that changing people’s drinking hours and consumption patterns reduces violence and hospital admissions.Peter Miller, Principal Research Fellow, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/310622014-09-02T04:39:59Z2014-09-02T04:39:59ZScapegoating steroids won’t make for a safer night out<figure><img src="https://images.theconversation.com/files/57971/original/hnmrxb24-1409621895.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Steroid use is growing in Australia but not among the usual suspects.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/japokskee/4391428993">Jhong Dizon/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Steroids are easy to scapegoat. Users are viewed as aggressive, violent and mentally unstable, able to snap at any moment and cause great harm to the people around them. </p>
<p>Ostensibly, it is this perception of steroid users that has led the Queensland government to enact <a href="http://www.premiers.qld.gov.au/publications/categories/plans/assets/safe-night-out-strategy.pdf">tougher penalties</a> for steroids. The Safe Night out legislation increases the maximum penalty for possession or supply of steroids to 25 years in jail. </p>
<p>But tougher steroid laws are unlikely to have an impact on violence in the community because a) most steroid users are not violent, and b) other substances, including alcohol, are stronger risk factors for violent behaviour.</p>
<h2>Who uses steroids?</h2>
<p>The public perception of steroid users doesn’t match the reality. </p>
<p>The first red flag comes from demographic data. It turns out that in the United States, the <a href="http://www.ncbi.nlm.nih.gov/pubmed/21923602">typical steroid user</a> is male, around 30 years old, has a bachelor’s degree, is employed full-time in a white-collar occupation, earns an above-average income, and does not play any form of competitive sport. Local data is lacking, but smaller studies of Australian steroid users <a href="http://www.sciencedirect.com/science/article/pii/S0376871600800113">corroborate this profile</a>.</p>
<p>In a <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2131752/">large US study</a> of nearly 2,000 steroid users, the most-commonly reported occupations were in sales and marketing, information technology, banking and finance, health care, management and executives, and skilled labour. The least-commonly held occupations? Athletes, coaches, personal trainers and the military. </p>
<p>So these men don’t sound like a particularly violent bunch, but aren’t steroids still linked with increased aggression and violent behaviour?</p>
<h2>How steroids affect behaviour</h2>
<p>Some <a href="http://www.sciencedirect.com/science/article/pii/S0018506X96900215">studies suggest</a> that steroid users are more aggressive and irritable than non-users. Further, some <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636528/">population-based studies</a> have <a href="http://www.ncbi.nlm.nih.gov/pubmed/8355384">found links</a> between self-reported anabolic steroid use and self-reported involvement in aggressive and violent behaviour. </p>
<p>Arguably, however, the best data comes from studies where anabolic steroid use is objectively tested and violent behaviour is confirmed through legal records rather than self-report. </p>
<p>To this end, a <a href="http://www.ncbi.nlm.nih.gov/pubmed/17088508">Swedish retrospective cohort study</a> that compared registered criminal activity among individuals who had tested positive for anabolic steroids to those who had tested negative for steroids found that those who tested positive were no more likely to have committed violent crimes. </p>
<p>In fact, after controlling for substance abuse, the researchers found a lower risk for crimes against property among those individuals who tested positive for anabolic steroids. </p>
<p>A general limitation of studies on steroid use and violent behaviour is that few have controlled for other forms of substance use, including alcohol. </p>
<p>A <a href="http://uu.diva-portal.org/smash/record.jsf?pid=diva2:601819">recent Swedish study</a> examined the link between anabolic steroid use and violent crime in a sample of 3,594 remanded prisoners and found that 28% reported using steroids at least once in their lifetime. Prisoners who reported any lifetime use of steroids were 1.7 times more likely to be suspected of a violent crime. However, there was no temporal relation between the use of anabolic steroids and the suspected violent crime. </p>
<p>In contrast, there was a four-fold increase in the risk of violent crime if alcohol had been consumed 24 hours earlier. The average amount of alcohol consumed in the 24 hours prior to a violent offence was 107 grams, equivalent to 10.7 Australian standard drinks.</p>
<p>A <a href="http://uu.diva-portal.org/smash/record.jsf?pid=diva2:601819">second Swedish population study</a> of 10,365 men found that 4.9% had been convicted for a violent crime and 0.7% reported anabolic steroid use. Further examination showed that violent offenders were five times more likely to report anabolic steroid use than non-offenders. </p>
<p>But after controlling for other forms of lifetime substance abuse, including alcohol, this association lost statistical significance. In other words, once the researchers looked at alcohol and other drugs, it appeared that anabolic steroids were not at all associated with violent crime. </p>
<p>Steroid use is probably not a proximal risk factor for violent behaviour. Rather, co-occurrence of abuse of other substances, including alcohol, are probably more to blame. Another possibility is that using anabolic steroids <a href="http://www.ncbi.nlm.nih.gov/pubmed/12048171">makes people more susceptible</a> to the violence-inducing effects of other substances such as alcohol or <a href="http://www.ncbi.nlm.nih.gov/pubmed/15763599">amphetamines</a>, an idea which has some support in animal research.</p>
<h2>Cost of penalising steroid users</h2>
<p>The potential benefit of tougher laws on steroid use to curb violence and antisocial behaviour must be weighed against the potential costs. The proportion of steroid users who disclose their use to health professionals, which is already low, will likely fall. </p>
<p>Community health-promotion services, such as needle exchanges, may see a drop in visits from steroid users concerned about the potential for discovery and prosecution.</p>
<p>Steroid use is undoubtedly growing in Australia. In New South Wales in 2007, <a href="https://kirby.unsw.edu.au/sites/default/files/hiv/resources/ANSPS_2008_2012%20KI.pdf">the proportion</a> of needle exchange service-users who reported that their last injection was steroids was just 2%. But by 2012 this had increased sixfold to 12%. Queensland <a href="https://kirby.unsw.edu.au/sites/default/files/hiv/resources/ANSPS_2008_2012%20KI.pdf">fared no better</a>: rising from 2% in 2007 to 11% in 2012. By 2012, almost two-thirds of all new service-users, or “new initiates,” reported that their last injection was anabolic steroids. </p>
<p>These men are not competitive athletes or criminals. Overwhelmingly, they are men who are unhappy with their appearance and want to look better. </p>
<p>For some, large parts of their self-worth or self-esteem are tied to their bodies and their appearance. If building muscle becomes a preoccupation, a mental condition called <a href="http://www.ncbi.nlm.nih.gov/pubmed/9427852">muscle dysmorphia</a>, formerly named <a href="http://www.ncbi.nlm.nih.gov/pubmed/8131385">“reverse anorexia”</a>, may develop. Little wonder that <a href="http://ajp.psychiatryonline.org/article.aspx?articleID=174271">up to 50%</a> of men with muscle dysmorphia also use steroids. </p>
<p>Derisively labelling steroid users as vain or narcissistic “gym bros” and disparaging their culture as “<a href="http://www.abc.net.au/news/2014-08-27/qld-beefs-up-steroid-laws-after-drastic-rise-in-seizures/5698532">bruss</a>” betrays a deep lack of compassion. There is a reason why extreme dieting and self-induced vomiting <a href="http://www.jeatdisord.com/content/1/S1/O23">grew faster</a> among Australian males than Australian females between 1998 and 2008 and a reason why teenage boys <a href="https://www.missionaustralia.com.au/2020-strategy-page/doc_download/198-mission-australia-youth-survey-2013">consistently rank</a> body image among their top three major life concerns. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/57972/original/qfmk7zq3-1409621973.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/57972/original/qfmk7zq3-1409621973.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/57972/original/qfmk7zq3-1409621973.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/57972/original/qfmk7zq3-1409621973.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/57972/original/qfmk7zq3-1409621973.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/57972/original/qfmk7zq3-1409621973.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/57972/original/qfmk7zq3-1409621973.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Male action figures are becoming bulkier.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ntxpeach68/6785168533">SandyJo Kelly./Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Our culture celebrates physically attractive and “masculine” men: tall, muscular, stiff upper-lipped. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18089212">Research shows</a> that media portrayals of men have become <a href="http://www.sscnet.ucla.edu/comm/haselton/papers/downloads/frederickbodyimage.pdf">more and more muscular</a> during the past few decades and the rise in steroid use in contemporary Australia is a symptom of men succumbing to body image pressures. </p>
<p>Solving this problem demands a compassionate understanding of the psychology behind why men start to use steroids. Too often we turn to outright denigration. We do not publicly berate girls for their attempts to look more attractive, so why do we berate men?</p>
<p>Tougher steroid laws are unlikely to have an impact on violence in the community. Rather, the steroid-using community will be driven further underground, making it more difficult to deliver health services to this misunderstood and under-served group of people, allowing the problem of steroids in Australia to grow even larger.</p><img src="https://counter.theconversation.com/content/31062/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>I am currently affiliated with the Butterfly Foundation, the Redleaf Practice, the Australian and New Zealand Academy of Eating Disorders, and the National Association for Males with Eating Disorders.</span></em></p>Steroids are easy to scapegoat. Users are viewed as aggressive, violent and mentally unstable, able to snap at any moment and cause great harm to the people around them. Ostensibly, it is this perception…Scott Griffiths, PhD candidate, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/255942014-04-15T04:30:04Z2014-04-15T04:30:04ZDead Drunk: alcohol, violence and a night in Kings Cross<figure><img src="https://images.theconversation.com/files/46313/original/bjq3wthh-1397440517.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Measures to reduce alcohol-fuelled violence will take time to really have an effect.</span> <span class="attribution"><span class="source">ABC TV</span></span></figcaption></figure><p>Two months after the <a href="https://theconversation.com/alcohol-and-violence-a-complex-issue-in-search-of-leadership-21886">death of 18-year-old Sydney man Daniel Christie</a>, who was punched to the ground on New Year’s Eve, New South Wales Premier Barry O’Farrell introduced a <a href="https://www.nsw.gov.au/newlaws">set of measures</a> aimed at improving the safety of nightlife in Sydney’s CBD and entertainment precincts. </p>
<p>Six weeks later, the ABC sent six crews into Kings Cross to see if they were working – and I tagged along. The finished product, a documentary called <a href="http://www.abc.net.au/tv/programs/dead-drunk-lights-out-in-the-cross/">Dead Drunk: Lights Out in the Cross?</a>, will screen tonight at 8.30pm, followed by a <a href="http://www.abc.net.au/tv/programs/dead-drunk-after-hours-with-tom-tilley/">forum on ABC2</a> involving many of the key stakeholders. </p>
<p>Six film crews followed a range of people between the hours of 7pm and 6am, including a hen’s night, a 21st birthday party, a team of police and others, in and around Kings Cross on the night of April 5. It also involved interviews throughout the night with licensees, industry representatives, party-goers – and me.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/46306/original/mb9thb8f-1397439660.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/46306/original/mb9thb8f-1397439660.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/46306/original/mb9thb8f-1397439660.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/46306/original/mb9thb8f-1397439660.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/46306/original/mb9thb8f-1397439660.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/46306/original/mb9thb8f-1397439660.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/46306/original/mb9thb8f-1397439660.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">I was interviewed several times throughout the night, beginning at 7pm and finishing around 5.30am.</span>
<span class="attribution"><span class="source">ABC TV</span></span>
</figcaption>
</figure>
<p>This fascinating experience came around because of <a href="http://www.ndlerf.gov.au/publications/monographs/monograph-43">my involvement</a> in the two <a href="http://www.ndlerf.gov.au/publications/monographs/monograph-46">largest studies</a> into nightlife, for which my colleagues and I interviewed over 11,000 patrons in six cities between 8pm and 5am and conducted more than 1,000 covert observations. I also worked as a bouncer many years ago. </p>
<p>Having collected such data, the opportunity to spend a night in the Cross following the introduction of the new legislation was extremely tempting.</p>
<h2>What did we see?</h2>
<p>To refresh your memory, the <a href="https://theconversation.com/nsw-response-to-alcohol-related-violence-is-an-important-first-step-22286">NSW government measures</a> to reduce alcohol-fuelled violence include:</p>
<ul>
<li>no alcohol sales at 3am</li>
<li>a 1am lockout (or “one-way door” where patrons cannot enter a venue after 1.30am)</li>
<li>a new risk-based liquor licensing framework</li>
<li>a system of fines for people being drunk or causing trouble on the streets</li>
<li>mandatory sentences for some alcohol-related crime and a range of minor conditions.</li>
</ul>
<p>The key element of the package is <a href="https://theconversation.com/nsw-response-to-alcohol-related-violence-is-an-important-first-step-22286">stopping</a> the service of alcohol at 3am. What has become clear is that many people confuse this with the “lock-out” which stops people entering venues after 1.30am.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/46308/original/czj5m6pv-1397439695.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/46308/original/czj5m6pv-1397439695.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/46308/original/czj5m6pv-1397439695.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/46308/original/czj5m6pv-1397439695.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/46308/original/czj5m6pv-1397439695.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/46308/original/czj5m6pv-1397439695.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/46308/original/czj5m6pv-1397439695.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We didn’t see the police having to issues fines, though this undoubtedly occurred.</span>
<span class="attribution"><span class="source">ABC TV</span></span>
</figcaption>
</figure>
<p>Our evidence, and very large body of international evidence, has shown that <a href="https://theconversation.com/nsw-response-to-alcohol-related-violence-is-an-important-first-step-22286">stopping</a> the service of alcohol reduces <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03125.x/abstract">assaults</a>, <a href="https://dro.deakin.edu.au/view/DU:30061472">emergency department attendances</a> and <a href="http://www.ndlerf.gov.au/publications/monographs/monograph-43">other harms</a>. And this was the case on the night. By 3.20pm, the streets were virtually empty and there was no obvious trouble associated with people going home, which is entirely consistent with the evidence but is contrary to much of the hype of those with vested interests.</p>
<p>However, the picture is complicated by the lockout. <a href="http://onlinelibrary.wiley.com/doi/10.1111/dar.12123/abstract">Our evidence</a> and <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1465-3362.2011.00375.x/abstract">previous work</a> has not found substantive benefits of this measure. And it’s clear this element of the new legislation is unpopular and can cause friction, especially in the early days when patrons are still getting familiar with the new laws.</p>
<p>Despite this, we didn’t see any violence on the night, nor did we see the police having to issues fines, although this undoubtedly occurred.</p>
<p>Of course, we saw many other things that night. Even long after the pubs had shut, there were some people hanging around and many of them were drunk and disruptive. Even at 5.15am, a young woman interrupted filming and offered the crew a blowjob. </p>
<p>Another young man waited until filming had stopped and then wanted to argue about the interventions, ignoring many attempts by us to walk away. These people argued that the new measures impinged on their rights to party, but they didn’t seem too worried about anyone else’s rights – a common theme.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/46305/original/2x9kpqp6-1397439659.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/46305/original/2x9kpqp6-1397439659.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/46305/original/2x9kpqp6-1397439659.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/46305/original/2x9kpqp6-1397439659.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/46305/original/2x9kpqp6-1397439659.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/46305/original/2x9kpqp6-1397439659.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/46305/original/2x9kpqp6-1397439659.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">If the measures are implemented around the state, people will go out earlier rather than going elsewhere.</span>
<span class="attribution"><span class="source">ABC TV</span></span>
</figcaption>
</figure>
<h2>It’s early days</h2>
<p>A key barrier to this type of investigation is that such measures take time to really have benefit – and we saw this in Newcastle. </p>
<p>The city went through an initial teething period in 2008 when lockouts were introduced and pubs were forced to close at 3.30pm. But the impact is continuing to be seen, with declining rates of violence <a href="http://onlinelibrary.wiley.com/doi/10.1111/dar.12123/abstract">still being reported</a>. </p>
<p>Further, the police are still flooding the streets in Kings Cross, which is absolutely necessary and the right thing to do when introducing such a change. But as we’ve seen with other measures, it can confuse the findings if not accounted for in any analysis. </p>
<p>Finally, culture change takes a bit of time (about 50 years for smoking). After five years of earlier trading in Newcastle, there are now more licensed venues than before (mostly small bars), 13 of the 14 venues originally subject to the conditions are still trading (one burnt down), people go out earlier and pre-fuel on cheap supermarket booze less, meaning they spend more money in the pubs. </p>
<p>The key will be how quickly the businesses in Kings Cross adapt their model from the one that has seen so much harm arise; I look forward to seeing what they come up with.</p>
<h2>What else could be done?</h2>
<p>A key discussion point, especially from the industry, is that the number of people going out is smaller (they always say this) and that people will go elsewhere, to regions that don’t have these restrictions. This is almost certainly true and hopefully someone is able to gather such data; we need this data to properly evaluate all impacts of the legislative changes.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/46309/original/q9rszx6y-1397439700.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/46309/original/q9rszx6y-1397439700.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/46309/original/q9rszx6y-1397439700.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/46309/original/q9rszx6y-1397439700.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/46309/original/q9rszx6y-1397439700.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/46309/original/q9rszx6y-1397439700.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/46309/original/q9rszx6y-1397439700.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Police are still flooding the streets in Kings Cross, which might confuse the findings.</span>
<span class="attribution"><span class="source">ABC TV</span></span>
</figcaption>
</figure>
<p>But, there is great misunderstanding about the reductions in numbers, because they are the consequence of people going elsewhere, not staying at home. </p>
<p>The key recommendation from our research is to ensure that such measures are implemented state-wide. Not doing so creates artificial and problematic flows of people to other entertainment districts which are even less equipped to deal with late-night patrons. Implementing the measures state-wide will result in people going out earlier, rather than going elsewhere and means that overall revenues will remain stable. </p>
<p>The current measures mean that people will go to venues that trade late when they want to party hard, disadvantaging central Sydney and creating many problems for outlying communities. The government has said if this becomes apparent, it will extend the areas where the measures are put in place. So we will need to see how this plays out. </p>
<h2>A final word</h2>
<p>Premier O’Farrell and the NSW government have shown leadership and acted meaningfully to reduce the level of alcohol-related harm on the streets of Sydney; something lacking in other states. </p>
<p>These measures address some of the key situational factors in alcohol-related violence. But if we truly want to deal with the issue, we need a <a href="https://theconversation.com/alcohol-and-violence-a-complex-issue-in-search-of-leadership-21886">more comprehensive, whole-of-government approach</a> that deals with all forms of violence throughout the lifespan, to prevent the next generation of offenders entering our schools, streets and pubs.</p>
<p><strong><em><a href="http://www.abc.net.au/tv/programs/dead-drunk-lights-out-in-the-cross/">Dead Drunk: Lights Out in the Cross?</a> will screen tonight at 8.30pm on ABC1, followed by <a>Dead Drunk: After Hours, a live chat with Tom Tilley</a>, at 9.30pm live (AEST) on ABC2.</em></strong></p><img src="https://counter.theconversation.com/content/25594/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Queensland government and Australian Drug Foundation, travel and related costs from Australasian Drug Strategy Conference. He is affiliated with academic journal Addiction.</span></em></p>Two months after the death of 18-year-old Sydney man Daniel Christie, who was punched to the ground on New Year’s Eve, New South Wales Premier Barry O’Farrell introduced a set of measures aimed at improving…Peter Miller, Principal Research Fellow, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/242122014-03-11T21:58:54Z2014-03-11T21:58:54ZAll in it together: why stopping alcohol’s harms needs everyone<figure><img src="https://images.theconversation.com/files/43575/original/dxxz5n5s-1394517945.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Neither communities nor governments can tackle alcohol problems alone. </span> <span class="attribution"><a class="source" href="http://www.flickr.com/photos/cunaldo/2902086659/sizes/o/">AndyCunningham/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p>Attempts by communities to reduce binge drinking and the violence that often accompanies it are unlikely to succeed without a supportive legislative framework, according to <a href="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001617?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+plosmedicine/NewArticles+(PLOS+Medicine+-+New+Articles)">research my colleagues and I have published today</a> in the journal PLOS Medicine.</p>
<p>We all want a night out with friends to not end in violence but this is the reality of drinking in many Australian towns and cities. State governments, like the one in New South Wales, react to such violence with legislation, but our research shows this may not be the whole answer either.</p>
<p>We’ve already shown that the level of alcohol harm in a community is clearly influenced by legislation; communities with more pubs and clubs (a marker of higher alcohol availability facilitated by government legislation) have <a href="http://onlinelibrary.wiley.com/doi/10.1111/1753-6405.12176/abstract">more risky drinkers</a> and <a href="http://alcalc.oxfordjournals.org/content/early/2011/05/04/alcalc.agr040">higher rates of alcohol-related crime</a>.</p>
<p>But five years of research has shown that one size doesn’t fit all when it comes to reducing alcohol-related harms. As the results of this work shows, the best way to make people safe from alcohol-fuelled violence is to have a collaborative approach where communities and governments work together to resolve the issue with research facilitating their efforts.</p>
<h2>What we did</h2>
<p>We worked with 20 regional NSW communities to measure the effectiveness of 13 community-based interventions. The population of the towns were between 5,000 and 20,000 and the interventions, which were developed in partnership with the communities where they were applied, ranged from education programs in schools and workplaces to early intervention at doctors’ clinics, pharmacies and hospitals, and targeting high-risk people at high-risk times, such as weekends.</p>
<p>Ten of the communities were randomly selected as the experimental towns, while nothing changed in the other ten. The impact of the changes were measured using surveys and data that is routinely collected by the police, hospitals and the NSW Roads and Traffic Authority (RTA).</p>
<p>We saw an overall drop in average alcohol consumption per head, which is important for reducing the risk of cancer and liver disease. And we also saw some lower-level impact, such as less verbal abuse on the streets. </p>
<p>But the big-ticket items on which the public is demanding action – reducing alcohol-related assaults and other crimes, preventing road traffic crashes, and curbing hospital admissions and individual binge drinking – didn’t significantly change in the ten intervention communities compared with the towns where nothing changed.</p>
<h2>Getting it just right</h2>
<p>Our findings have two important implications. In order to reduce risky drinking and harms across the board, it seems that communities can’t go it alone – we’re going to need a complementary and effective combination of community action and government legislation. </p>
<p>Our research supports the argument made by governments and the World Health Organization that local communities ought to look for local solutions because <a href="http://alcalc.oxfordjournals.org/content/early/2011/05/04/alcalc.agr040">alcohol crimes</a>, <a href="http://onlinelibrary.wiley.com/doi/10.1111/1753-6405.12176/abstract">rates of drinking</a>, and <a href="http://www.sciencedirect.com/science/article/pii/S0001457511001734">traffic crashes</a> differ significantly between communities. </p>
<p>But communities working alone will struggle to reduce harms at the severe end of the spectrum. Effective action is likely to require balanced legislation; if the legislative framework is too loose, we can expect more harms (for instance, if alcohol licenses are given out easily) and if it’s too restrictive, it’ll impact unfairly on people who drink sensibly. </p>
<p>It’s not clear from our study why some communities were better able to adapt to reducing drinking and some harms than others. But what this means is that we have to be very careful about simply applying what works in one place to another.</p>
<h2>Rethinking interventions</h2>
<p>To a large extent, the legislation recently introduced in New South Wales and others like it have been introduced blind with no “real time” evaluation built into the new model. We’re now working on practical, rigorous new methods that would support partnerships between researchers, communities and governments to address this. </p>
<p>There are many ways to do this, including new approaches to <a href="http://www.ajpmonline.org/article/S0749-3797%2807%2900280-2/abstract">designing evaluations</a> of interventions, and getting better at using data routinely collected by NSW police and roads authorities like the <a href="http://www.sciencedirect.com/science/article/pii/S0001457511001734">RTA</a>.</p>
<p>Our study shows we can change our drinking habits for the better and that this can result in beneficial outcomes for everyone in the community. It might also show that a new generation of partnership-based public health evaluations is closer than we think.</p>
<p>Such evaluations meet governments’ need to obtain measurable outcomes of improvement and the cost of achieving those gains; they respect the knowledge, skills and rights of communities to determine their own solutions; and they will give us the confidence to say our interventions reflect the most current research evidence.</p>
<p>What remains is addressing the logistical problem of establishing new frameworks to facilitate our own field of dreams – integrating evaluation routinely into community action and government legislative initiatives: build the framework and we will come.</p><img src="https://counter.theconversation.com/content/24212/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anthony Shakeshaft receives funding from the National Health and Medical Research Council, the Australian Research Council, the NSW Ministry of Health and the Foundation for Alcohol Research and Education.</span></em></p>Attempts by communities to reduce binge drinking and the violence that often accompanies it are unlikely to succeed without a supportive legislative framework, according to research my colleagues and I…Anthony Shakeshaft, Associate Professor and Deputy Director at National Drug and Alcohol Research Centre, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.