Reducing harm associated with the nighttime economy: Contributions to the evidence base

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Reducing harm associated with the night-time
economy Contributions to the evidence base

• John Wiggers
• Hunter New England Population Health

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Presentation Overview

• Reducing harm associated with the night-time
  economy
• Need for further harm reduction strategies
• Existing evidence regarding what may work
• Contributions to the evidence base
• Building the capacity of licensees
• Multi-strategy enforcement approach

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Need for further harm reduction strategies

• Service to intoxicated patrons
• Briscoe and Donnelly, 2002
• 55 of intoxicated young people continued to be
  served
• Gillham et al, unpublished
• 80 of premises had intoxicated patrons
• 95 of intoxicated patrons served alcohol
• 75 - 3 or more times
• Up to 10 more times

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Existing evidence

• Babor T et al, 2004. Alcohol - No ordinary
  commodity
• Highly effective
• Moderately effective
• Limited effectiveness
• Not effective 0
• National Drug Research Institute 2007
• Restrictions on the sale and supply of alcohol
  Evidence and Outcomes
• Strong ve evidence
• Some ve evidence
• Further evidence needed ?
• No ve evidence X

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Existing evidence
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Existing evidence
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Existing evidence
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Existing evidence
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Contributions to the evidence base

• Building licensee capacity

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Building licensee capacity

• Covert observations of premises during peak
  periods
• Environmental lighting, seating, ventilation,
  crowding, cleanliness
• Management trading hours, RSA policies,
  security/ staffing
• Staff behaviour
• Service to pseudo-intoxicated patrons
• Service to pseudo-underage patrons

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Building licensee capacity

• Tailored feedback reports
• Premises results for each criterion
• Rationale for modifying deficits and
  recommendations
• Group results (peer comparison)
• Feedback reports delivered by face to face
  educational session
• Comprehensive resource kit to help facilitate
  recommended changes

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Building licensee capacity

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Building licensee capacity

• Conclusion
• Audits/feedback alone can be sufficient to reduce
  crime
• Opportunity for police/licensing agencies to
  adopt enhanced audit/feedback method?

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Contributions to the evidence base

• Multi-strategy enforcement approach

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Multi-strategy enforcement

• Newcastle Intervention
• Formal action
• Reduced trading hours
• Lockout curfew
• Enhanced RSA
• Management plan
• Compliance audits
• Limit strength of alcohol after 10pm
• RSA marshalls
• Radio network
• Enforcement, transport
• Community group

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Newcastle Intervention

• Preliminary Evaluation
• Assault-related Emergency Department
  presentations between 10pm and 6am on Friday and
  Saturday nights for a 28 week period (21st March
  to 2nd October 2001 to 2008)
• 2 Proximal hospitals
• 2 Distal hospitals

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Newcastle Intervention

• Results
• Proximal hospitals In 2008, 132 presentations
  predicted, 95 presentations recorded (28 fewer
  incidents)
• Distal hospitals No significant difference

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Multi-strategy enforcement

• Conclusion
• Formal actions involving multiple strategies have
  a role to play in addressing harm
• The problem remains not a silver bullet
• Requires additional strategies
• more stringent regulation?
• Other strategies?

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Conclusion

• Regulatory approaches have strongest evidence
  density, tax, hours, enforcement
• Suggested support by Newcastle intervention
  (stick)
• Potential for industry capacity building approach
  (carrot)
• Need for further research to prove effectiveness
  (in real world) of capacity building

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Acknowledgements

• NHMRC