Evidence Check confirms links between alcohol availability and violence

A Sax Institute rapid review of latest evidence on the hot topic of alcohol availability, consumption and harms reveals there is high-quality evidence showing that both the density of liquor outlets and alcohol trading hours are associated with rates of violence.

The Evidence Check on the Community Impact of Liquor Licences, which was commissioned by the NSW Ministry of Health last year and published recently, covered 191 studies on alcohol availability and harm published between 2005 and 2015.

The review focused on two main areas – the density of alcohol outlets and the trading hours for alcohol sales – and comes amid heated debate over lockout laws and alcohol sale restrictions introduced in NSW in 2014 and more recently in Queensland.

Alcohol outlet density and harms

The researchers found there was high quality, locally relevant evidence that the density of alcohol outlets – such as pubs and bars – is related to rates of violence. When looking at the density of bottle shops (off-premise or packaged outlet density), the findings suggested it was the volume of sales, rather than the number of outlets that had the most influence on rates of harm.

Most studies, including two longitudinal Australian studies, showed that increases in alcohol outlet density were also associated with poorer health outcomes, including increased alcohol-related presentations to emergency departments.

The Evidence Check also showed there was strong Australian evidence that increased alcohol density was associated with increased rates of assault and family violence.

However, the researchers said there were almost no studies evaluating the impact of restrictions on the number or density of alcohol outlets — largely because such restrictions had rarely been implemented.

The impact of restricting trading hours

Reducing the hours during which pubs and bars could sell alcohol late at night could substantially reduce rates of violence, according to a series of robust, well-designed Australian studies, the review found.

“Increasing trading hours tends to result in higher rates of harm, and restricting trading hours tends to reduce harm,” the report states.

The Australian data was supported by a growing body of international research, and the evidence was strong enough to consider restrictions on late trading hours for bars and pubs as a key approach to reducing late-night violence in Australia, the researchers concluded.

The researchers further analysed their findings from 21 studies on alcohol trading hours in a separate paper published in the Sax Institute peer-reviewed journal Public Health Research & Practice.

They said there were few studies focusing specifically on lock-out policies, but research from Newcastle, NSW – where both a lock-out and mandated closing time were introduced – suggested that closing times may be the key driver to reductions in violence.

Other policy approaches

In terms of other approaches to reducing alcohol related harm, they suggested there was good evidence that interventions combining education and enforcement could help prevent underage drinker from purchasing alcohol from retail outlets.

However, there was no evidence looking into the effectiveness of different approaches to facilitating community input into liquor licensing decisions.

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