Alcohol misuse: tackling the UK epidemic - London

BMA Board of Science
Tougher enforcement policies were introduced by the Licensing Act 2003 in England and Wales,
including increased penalties for breach of licence conditions, additional powers for the police to
deal with troublesome premises (eg removal or suspension of licence and limiting opening hours)
and the use of test purchases. These are accompanied by increased powers to prohibit anti-social
drinking in areas where there has been a history of alcohol-fuelled disorder, as well as powers
banning individuals responsible for alcohol-related disorder from entering licensed premises or
specific public areas. Similar provisions have also been proposed in the licensing reforms in
Scotland and Northern Ireland. It is essential that these powers are strictly and rigorously enforced,
and that the enforcement agencies are adequately funded and resourced. In the UK, the
enforcement of licensing regulations is undertaken by the police in conjunction with local
authorities and Trading Standards Officers. These authorities have numerous responsibilities and,
consequently, the enforcement of alcohol licensing regulations is not adequately prioritised.
International experience suggests that the use of a dedicated licensing and inspection service
covering all licensed premises increases compliance with regulations and prohibitions on alcohol
sales. Such a system has been introduced in the Netherlands where a dedicated alcohol control
service consisting of approximately 70 inspectors has been found to have a significant effect on
reducing the rate of violent crimes between 10pm and 6am. 160
There is evidence that premises where there is little seating, loud music, crowding, large numbers
of young customers and poorly-trained staff are particularly likely to fuel heavy drinking and
4, 8, 114, 148
alcohol-related crime and disorder. Other factors that have been found to be associated
with alcohol-related violence include hidden areas, dark and noisy environments, poorly
maintained premises, low cleanliness, and poor ventilation. 148
The layout, design and internal
physical characteristics of licensed premises are therefore important considerations when planning
strategies to reduce alcohol-related crime and disorder.
An aggressive approach by staff at closing time and the inability of staff to manage problem
114, 148, 161, 162
behaviour are also important factors that may increase alcohol-related problems.
Responsible beverage service training is designed to alter attitudes, knowledge, skills and practices
among individuals serving alcohol. Such programmes have been shown to increase the likelihood
of servers intervening with customers who are visibly intoxicated, 163
and to decrease bad serving
practices such as promoting particular beverages. 114
While server training is less likely to increase
163, 164
actual refusal of service to intoxicated patrons, it has been found to reduce levels of patron
intoxification when accompanied by policing enforcement, and strong and active management
114, 153
support. Community-based approaches focused on licensed premises have been found to be a
powerful mechanism for reducing problem behaviour, although the long-term efficacy of this
approach has not been demonstrated. 114
Voluntary codes of practice have only been shown to be
effective when combined with community pressure from the police and public. 114
The implementation of responsible service training when combined with rigorous enforcement can
lead to improved management practices within drinking venues. This in turn can lead to reduced
levels of intoxication and an associated reduction in alcohol-related problems. It is important that
this training is compulsory and extended to staff working in off-licence premises.
Alcohol misuse: tackling the UK epidemic 53