Technical Paper 3:
Preventing Alcohol-related harm in Australia: a window of opportunity
4.2 - Regulating the physical availability of alcohol
Regulating physical availability refers to the accessibility or convenience of the alcohol products, and relates to policies that aim to prevent alcohol-related harm through controls on the condition of sale to the drinker as a retail customer. In Australia, there has been a recent review of the evidence for restricting the sale and supply of alcohol by the National Drug Research Institute. While regulation of the ‘economic’ availability of alcohol (i.e. the price of alcohol) is, currently, exclusively a federal responsibility in Australia, via measures such as taxation, the physical availability of alcohol is generally regulated by state and territory governments, and to a limited extent by local governments.
Restricting the hours and days of sale of alcohol is a standard component of alcohol policy and regulation, and there is a substantial body of international and Australian work that has examined the impact of changes to trading hours for licensed premises on levels of alcohol consumption and rates of related harms. Most Australian studies have shown that increased trading hours have been accompanied by significantly increased levels of alcohol consumption and/or harms. A recent Australian study by Chikritzhs and Stockwell found that small extensions of trading hours for licensed hotels in Perth, Western Australia, significantly increased the numbers of drink-driver road crashes. More specifically, this study demonstrated that the relationship between trading hours and increased drink-driver road crashes was mediated by the quantity of alcohol purchases. The National Drug Research Institute (NDRI) reports that several studies have indicated that young males and regular heavy drinkers are especially likely to take advantage of longer trading hours.
Restrictions on density of outlets can be achieved by requiring minimum distances between outlets or limiting the number of outlets in a particular location.
Liquor licensing systems or planning controls can potentially be used to limit the number of places where alcohol can be sold. In recent years in Australia there has been a significant liberalisation of licensing laws and a corresponding growth in outlets, both on- and off-premises. Recent research from three states,[45-49] has demonstrated consistent links between the availability of alcohol in a region and the alcohol-related problems experienced there. In particular, these studies have linked rates of violence to density of alcohol outlets. A longitudinal study in Melbourne has highlighted that changes in the number of outlets in an area are directly related to changes in the rates of night-time assaults occurring there. The links between outlet density and other outcomes are less clear cut, although some international evidence suggests higher outlet density is related to higher rates of: risky alcohol consumption, motor vehicle accidents, risky sexual behaviour, pedestrian injury, child maltreatment and neighbourhood amenity problems. The results of this research are clear: liberalising alcohol availability is likely to increase alcohol-related problems. The results certainly call into question the general assumption behind actions in recent decades that have been made in accordance with National Competition Policy such as the state-led liberalisation of liquor licensing regimes – that the number of a type of outlet should be determined by market demand for the product, without consideration of community amenity or impacts.
Apart from issues of outlet density, there is the question of whether particular types of outlets or their design and location are particularly likely to cause problems. There is good evidence that certain premises contribute disproportionately to problems, highlighting the need to further examine the types of outlets that are related to assaults. Further data, such as alcohol sales, opening hours, capacity and venue style, could provide substantial insights into how different outlets contribute to the effect of outlet density on assault.
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Growth in alcohol outletsWhile not completely deregulated, liquor licensing laws and regulations in most jurisdictions have been significantly relaxed over the past decade, generally coinciding with the required reviews under the National Competition Policy. One of the effects of this has been a proliferation in the number of new licensed premises in some jurisdictions (see Fig. 8).
Along with an increase in the total number of licensed premises, there has been an increase in the numbers of premises with extended trading hours, the numbers of licences to sell packaged liquor (i.e. take away) and over time, an increased concentration of licences held by just a few businesses.
Figure 8: Number of liquor licences by year, Victoria, 1986 to 2006
Restricting availability by alcohol strength
is known to be an effective intervention, both internationally and in Australia. In Australia, it has been estimated that full-strength beer makes the largest single contribution to all risky and high-risk alcohol consumption (39%). The National Drug Research Institute (NDRI) reports that studies that have examined the relationship between alcoholic beverage type and levels of alcohol-related harm have found increasing evidence that beer consumption is more commonly associated with drink-driving. The NDRI also observes that while most studies identify wine as a comparatively low-risk beverage, a study by Stockwell et al
. (1998) found that certain types of wine that offer high alcohol content at a relatively low price were strongly associated with hospitalisations for alcohol-related road injuries, falls, assaults and suicides. Some small regional or remote communities in Australia, with relatively large Indigenous populations, have introduced sales bans
on cask wine and cask fortified wine. According to the NDRI, evaluations of some of these bans show that such restrictions can result in reduced alcohol-related harm in the communities where the bans exist.
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The issue of the server liability
for injuries to intoxicated people or third parties affected by the actions of a person affected by alcohol is a complex and controversial area of the law. In the US, ‘Dram Shop’ laws and court decisions under common law in many states allow people injured through the actions of an intoxicated person to recover damages from a licensee or licensed premises owner. Such licensees are, in most Dram Shop legislation, also vicariously liable for their employees’ actions in serving an (intoxicated) patron. Loxley et al
. report that studies show Dram Shop laws have a modest deterrent effect, and that the underlying rationale for discouraging service of intoxicated persons is sound and there is no likelihood of adverse consequences. A recent Australian review of the key aspects of law and the implications of recent court decisions has reported that there is now a less onerous duty of care imposed on licensees and their staff with regard to the consequences of serving alcohol. (See also the discussion of responsible service of alcohol (RSA) interventions in Section 4.6 of this paper).
Minimum legal purchase
age refers to the age at which alcohol can actually be purchased by a person. This is distinct from the age at which alcohol can be consumed, sometimes referred to as the legal drinking age.
The distinction is important because while all state and territory laws in Australian prohibit a minor from purchasing alcohol, they do not necessarily prohibit consumption in certain circumstances. Babor et al
. emphasise that consistent enforcement
of laws regarding purchase age is critical if reduced alcohol consumption and related harm among young people is to be achieved. Although the minimum legal purchase age for alcohol in all Australian jurisdictions is 18 years, the average age at which Australians have their first full serve of alcohol is 17 years, and as detailed earlier in this paper, there is a high prevalence of underage drinking that has not changed significantly in the past 20 years. In the US, where the minimum legal purchase age for some time ranged between 18 and 21 years, several studies have found that increasing the age limit is an effective means of reducing road crash death and injury among teenagers and young adults. The NDRI reports that some studies have also found that the higher legal minimum drinking age is associated with reductions in alcohol consumption among young people. There is, therefore, some evidence that raising the purchase age to 21 can reduce teenage drinking, as well as harms. Kypri’s account of recent attempts to increase the minimum purchase age in New Zealand to 20 demonstrated that popular debate convinced a majority of the public that raising the age would be an appropriate way to reduce young people’s harm from drinking. Toumbourou et al
. here in Australia have recommended that a first step in this direction would be better monitoring of alcohol-related developmental harms using longitudinal and other developmental research.
It must be acknowledged that consumption of alcohol by children and adolescents in the home and in certain social settings is often sanctioned by parents, often in the belief that it is relatively harmless or might be helpful in educating young people about alcohol. The majority of young Australians who report drinking at home also report parents as being the primary suppliers of their alcohol.
In New South Wales, it is now an offence to supply alcohol to minors in a private home without the direct approval of a parent or guardian. This has often been referred to as the NSW secondary supply law
. While the impact of this law on youth drinking is not yet known, legislation of this kind has been welcomed by advocates against alcohol-related harm and there is currently considerable lobbying of government to support the introduction of similar laws in other Australian jurisdictions.
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Another example of restrictions on the physical availability of alcohol, which is known to be effective in reducing alcohol-related harm in some Australian Indigenous communities, is referred to as dry community declarations
. Some remote Indigenous communities in Western Australia, the Northern Territory and South Australia have declared themselves ‘dry’, using provisions of state/territory legislation. The key element of such dry area declarations is a combination of Indigenous community control and statutory authority, along with police enforcement for ensuring that dry community declarations reach their potential. Evidence suggests that although there are shortcomings (for example, sly grogging) and associated costs to this approach, overall there are reductions in consumption and alcohol-related harm. It should be noted that dry community declarations are distinct from local dry area alcohol bans
, as the latter relate to restrictions on drinking in designated public places and are usually imposed where there are high rates of alcohol-related public disorder. While local dry area bans have been found to decrease public order problems in designated areas, overall it is not yet fully known if they reduce public order offences, alcohol-related hospitalisations or police detentions of intoxicated persons. Often dry area restrictions simply displace drinkers to other areas where there are no, or fewer, restrictions, and dry area declarations are often seen as inherently discriminatory because of the negative impacts on Indigenous people already at risk of alcohol problems.
Currently receiving considerable attention in some Australian jurisdictions are measures related to restricting the hours of sale of alcohol, known as lockouts
. These do not restrict trading hours per se, however, because outlets are permitted to continue trading until their usual closing times. However, after a certain time, such as 2:00am or 3:00am, new
patrons and those wishing to re-enter the premises are not permitted to do so. Lockouts aim to reduce the movement of people between clubs after a certain time, since it is this movement of people between venues that police have reported as being a major cause of alcohol-related incidents late at night. There are examples of lockout programs in operation in locations throughout Australia, such as in Ballarat and Bendigo in Victoria, and across Queensland, where a 3.00am lockout now applies to all late-night licensed premises. The Victorian government has also trialled a 2.00am lockout throughout four inner-city municipalities of Melbourne. The NDRI reports that, as yet, there is limited formal evidence of the effectiveness of lockout programs, in part because they often occur as one element within a range of programs aimed at reducing late-night alcohol-related problems (for example, CCTV cameras, street lighting, public transport, police presence).
While they are not usually focused solely on issues that relate to the physical availability of alcohol, community-based prevention
programs have become increasingly popular in recent years because of emerging understandings of how environmental and social conditions contribute to alcohol problems. A detailed discussion on the range and scope effects of community based programs is not provided here, but can be obtained elsewhere (see Loxley et al.