Impacts of public drinking laws

This bulletin presents the results of a research project evaluating the impact of prohibitions on public drinking in three local government areas in New South Wales. Introduction Policies that restrict the spaces in which alcohol can be consumed are now widely implemented around the world. Bans on the public consumption of alcohol are particularly common in Western countries, including North America, the United Kingdom, Nordic countries, Australia and New Zealand. In Australia, partial or complete bans on drinking in public operate to some degree in all major cities, as well as in many regional and rural towns. Public drinking bans have different names, including dry areas, alcohol-restricted areas, liquor bans, open container laws, alcohol-free zones and alcohol-exclusion zones. There are jurisdictional differences for public drinking laws in Australia, whereby they are a matter of state/territory legislation in some jurisdictions and local council laws in others. In Victoria, public drinking laws are designed, enacted and controlled by local government, but are enforced by state government (police). This means that the provisions of these laws, including which spaces are included and exempt and during what hours the law operates, often differ between local government areas (LGAs), even if they are directly adjacent to one another. It also means that such laws require a considerable degree of cooperation and coordination between local council officers and police. It is only really in the past 10 to 15 years that public drinking bans have proliferated across urban centres in Australia. What is interesting about this timing is that this is also the timeframe in which drinking on the street has become increasingly legitimised in the form of licensed restaurant/bar/hotel footpath trading. Despite the many vested interests involved in public drinking bans, including local council employees, elected councillors, police, licensees, traders, drinkers and community members, and despite the recent proliferation of these drinking bans in urban areas, there have been very few evaluations of their impact or effectiveness throughout the world.   Authored by Amy Pennay, Elizabeth Manton, Michael Savic, Michael Livingston, Sharon Matthews & Belinda Lloyd

Exploring the micro-politics of normalised drug use in the social lives of a group of young 'party drug' users in Melbourne, Australia

Young people today live in what some scholars and commentators have defined as a 'post-modern' era, characterised by globalisation, the internet, mass media, production and consumption. Post-modernity has seen a change in the way young people live. Along with career, finance and success, young people today place greater emphasis on leisure, identity, relationships and health. There is some evidence to suggest that other factors, such as family, community and location, have become less important for young people living in the new millennium (Giddens 1991; Beck 1992).In post-modern times, there has been a significant increase in western countries in the use of 'party drugs', including ecstasy and methamphetamine, among 'ordinary' young people in social and leisure-oriented contexts. In the mid-1990s, in response to this rise in drug use, a team of UK researchers developed a theoretical framework in which they argued that the use of some illicit drugs had become 'normalised' (Parker, Aldridge et al. 1998). The proponents of the normalisation thesis suggested that drug use was no longer linked with deviant, pathological or subcultural behaviour, and had become a normal feature of the day-to-day worlds of many young people.This thesis explores the concepts of post-modernity and normalisation as they relate to the culture and practices of a group of young people in Melbourne, Australia, who called themselves the 'A-Team'. The A-Team was a social network of around 25 people who were 'typical', „mainstream‟ and 'socially included' individuals (Hammersley, Khan et al. 2002; Harling 2007), who participated in work and study, and who did not engage in any illicit activity other than drug use.I argue that theories of post-modernism and normalisation emphasise too strongly macro-level changes and do not adequately appreciate the complexity of social process and the cultural meanings negotiated within and through the practices of individuals and groups. For example, while theories of post-modernity have shed light on the way in which lives are structured at the macro level, they less adequately account for the way that young people continue to make and re-make meaning and identity from enduring social relationships and particular social contexts.In response to an increasingly globalised and disconnected world, A-Team members found continuity and stability within the group. They remained 'modern' in their adherence to their social community; however, the form of community they sought took a very post-modern form. They experimented with self-expression and identity outside the confines of traditions such as marriage, family and career, but they did not drift between groups and social spaces in their search for self. They were selective with whom and where they performed their desired identities. The A-Team practiced a form of 'differentiated' post-modernism, which presents a more complex picture of how young people are responding to macro-level social, cultural and economic changes.Throughout this thesis I describe the multiple ways in which A-Team members attempted to manage their use of alcohol and party drugs within their „normal‟ suburban lives. In particular, I highlight the ways in which they engaged with discourses of 'normal' and 'abnormal' drug use and 'acceptable' and 'unacceptable' drug use. I also describe the ways in which they engaged with discourses of moderation and excess, and the desire for both self-control and 'controlled loss of control' (Measham 2004a). These discourses arose as a consequence of a range of competing tensions that the A-Team consistently managed. These tensions included the search for bodily pleasure, identity and the desire for intimate social relationships, experiences of drug-related harm and significant critiques of specific forms of drug use from group members, and from non-drug using friends and family.In highlighting these discourses and competing tensions, I argue that although the normalisation thesis has significantly advanced understandings of young people's drug use, it does not adequately appreciate the way that young people must negotiate the 'micro-politics' of normalised drug use, a concept recently outlined by Swedish sociologist Sharon Rodner Sznitman (2008). Rodner Sznitman argued that normalisation is an ongoing process shaped by unique social and cultural micro-politics. Rodner-Sznitman suggested that young drug users engage in practices of 'assimilative normalisation' – by attempting to manage their 'deviant' or stigmatised behaviour – and 'transformational normalisation' – by attempting to resist or redefine what is considered to be 'normal' with respect to illicit drug use and drug users.I describe how A-Team members engaged in practices of assimilative normalisation by concealing their drug use from disapproving friends and family, severing ties with some non-drug using friends, repeatedly attempting to cease or reduce their drug use, drawing on notions of 'controlled' and 'moderate' use as the most acceptable form of drug use, and justifying their drug use as a temporary feature of young adulthood. I also show how some A-Team members engaged in transformational normalisation by rejecting the need for moderate or controlled forms of consumption, attempting to redefine the boundaries of socially acceptable drug-using behaviour and by offering an alternative reading of ecstasy as a drug that enables the performance of an intoxicated self.This research shows that there are many competing social and cultural forces that shape the way that young people use drugs and understand their use. It is essential that we develop a greater understanding of young people's drug use and not interpret their drug using practices through frameworks that rely on macro-level cultural and/or attitudinal shifts. Young recreational drug users face a multitude of issues when attempting to manage their drug use amidst the competing demands of relationships, sport, work, finances and career. These issues and the responses adopted by young drug users are likely to vary between groups, between cultures and between types of drug use

Prohibiting public drinking in an urban area: determining the impacts on police, the community and marginalised groups

With public drinking laws proliferating across urban areas over the past 15 years, this project evaluated the implementation of these laws, their effectiveness, and their impact on a range of target groups including police, residents, traders, local health and welfare workers, and potentially marginalised groups. Overview Public drinking laws have proliferated across urban areas over the past 15 years; however, there have been very few evaluations of their impacts and effectiveness. The purpose of this project was to evaluate public drinking laws across three diverse inner-urban local government areas (LGAs) of Melbourne: the Cities of Yarra, Darebin and Maribyrnong. The objectives of this project were to evaluate the implementation of public drinking laws, the effectiveness of these laws and the impact of these laws on a range of target groups including police, residents, traders, local health and welfare workers, and potentially marginalised groups. The evaluation produced equivocal findings in relation to whether public drinking laws reduced congregations of drinkers (with differing findings across municipalities) and there was no evidence that these laws reduced alcohol-related crime or harm. However, public drinking laws do make residents feel safer and improve the amenity of an area from the perspective of residents and traders. The evaluation found that public drinking laws often result in negative impacts to marginalised individuals and this requires more consideration in the implementation and enforcement of these laws. It is important that public drinking laws are carefully considered, implemented and enforced (with local council officers and police liaising collaboratively to respond to the needs of the individual community) and are coupled with community-specific social inclusion strategies

Awareness of energy drink intake guidelines and associated consumption practices: a cross-sectional study

BACKGROUND: Despite concern regarding harms of energy drink (ED) consumption, no research has been conducted to determine awareness and compliance with ED intake guidelines displayed on product packaging in Australia (a novel approach internationally). METHODS: A convenience sample of 1922 people completed an online survey. Participants reported their knowledge of maximum recommended daily ED intake according to Australian guidelines. RESULTS: Guideline awareness was reported by 38, 23 and 19 % of past year consumers, lifetime, and non-consumers, respectively. Amongst past year consumers, \u27accurate estimators\u27 reported greater ED intake and were more likely to exceed intake guidelines and consume alcohol mixed with ED (AmED). After controlling for demographics and frequency of use, guideline awareness predicted increased likelihood of exceeding guidelines in ED sessions, but was not associated with exceeding ED guidelines in AmED sessions. CONCLUSIONS: Australia is considered to have the most stringent regulatory approach to EDs internationally. However, advisory statements are not associated with greater awareness and compliance with intake guidelines. Failure to comply with standards for efficacious product labelling, and absence of broader education regarding guidelines, needs to be addressed

The Association between the Police, Ambulance, Clinician Early Response (PACER) Model and Involuntary Detentions of People Living with Mental Illness: A Protocol for a Retrospective Observational Study

Emergency services are frequently called to attend mental health incidents and are looking for innovative ways to improve their responses and reduce the burden on services. Involuntary detention of people living with mental illness is considered more frequent than necessary, leading to increased pressure on emergency departments, and is often a traumatic experience for patients. The Police, Ambulance, Clinician Early Response (PACER) model was developed in 2019 in Canberra, Australia, and seeks to reduce involuntary detentions by embedding a mental health clinician into emergency services as a mobile mental health crisis response intervention. This protocol details a retrospective cohort study that will examine the association between PACER and involuntary detentions using medical and police records and compare the results to standard ambulance and police responses. We will use relative risk and odds ratio calculations to determine the probability of being involuntarily detained or diverted from hospital; and we will describe the patient characteristics and outcomes in the PACER cohort. Results will be reported using the STROBE checklist for reporting cohort studies. This study was not registered on a publicly accessible registry

Patron offending and intoxication in night time entertainment districts (POINTED) : a study protocol

Risky alcohol consumption is the subject of considerable community concern in Australia and internationally, particularly the risky drinking practices of young people consuming alcohol in the night-time economy. This study will determine some of the factors and correlates associated with alcohol-related risk-taking, offending and harm in and around licensed venues and night-time entertainment precincts across five Australian cities (three metropolitan and two regional). The primary aim of the study is to measure levels of pre-drinking, drinking in venues, intoxication, illicit drug use and potentially harmful drinking practices (such as mixing with energy drinks) of patrons in entertainment areas, and relating this to offending, risky behaviour and harms experienced. The study will also investigate the effects of license type, trading hours, duration of drinking episodes and geographical location on intoxication, offending, risk-taking and experience of harm. Data collection involves patron interviews (incorporating breathalysing and drug testing) with 7500 people attending licensed venues. Intensive venue observations (n=112) will also be undertaken in a range of venues, including pubs, bars and nightclubs. The information gathered through this study will inform prevention and enforcement approaches of policy makers, police and venue staff.<br /

Youth drinking in decline: What are the implications for public health, public policy and public debate?

Youth drinking has declined across most high-income countries in the last 20 years. Although researchers and commentators have explored the nature and drivers of decline, they have paid less attention to its implications. This matters because of the potential impact on contemporary and future public health, as well as on alcohol policy-making. This commentary therefore considers how youth drinking trends may develop in future, what this would mean for public health, and what it might mean for alcohol policy and debate. We argue that the decline in youth drinking is well-established and unlikely to reverse, despite smaller declines and stabilising trends in recent years. Young people also appear to be carrying their lighter drinking into adulthood in at least some countries. This suggests we should expect large short- and long-term public health benefits. The latter may however be obscured in population-level data by increased harm arising from earlier, heavier drinking generations moving through the highest risk points in the life course. The likely impact of the decline in youth drinking on public and policy debate is less clear. We explore the possibilities using two model scenarios, the reinforcement and withdrawal models. In the reinforcement model, a ‘virtuous’ circle of falling alcohol consumption, increasing public support for alcohol control policies and apparent policy successes facilitates progressive strengthening of policy, akin to that seen in the tobacco experience. In the withdrawal model, policy-makers turn their attention to other problems, public health advocates struggle to justify proposed interventions and existing policies erode over time as industry actors reassert and strengthen their partnerships with government around alcohol policy. We argue that disconnects between the tobacco experience and the reinforcement model make the withdrawal model a more plausible scenario. We conclude by suggesting some tentative ways forward for public health actors working in this space

Patterns in reduction or cessation of drinking in Australia (2001-2013) and motivation for change

Aims: This paper examines: 1) change over time (2001-2013) in recently reducing or ceasing drinking in the Australian population, and 2) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. Methods: Data are from five waves of the National Drug Strategy Household Survey (N=119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking, and to predict motivations for reducing or ceasing drinking by sex and age. Results: Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007, and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons, and younger people more likely to report lifestyle reasons or enjoyment. Conclusion: Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons, suggests that the social position of alcohol in Australia may be shifting, particularly among young people

Response to commentaries: (de)normalization of drinking and its implications for young people, sociality, culture and epidemiology

Commentar

Sober Curiosity: A Qualitative Study Exploring Women’s Preparedness to Reduce Alcohol by Social Class

Background: Urgent action is required to identify socially acceptable alcohol reduction options for heavy-drinking midlife Australian women. This study represents innovation in public health research to explore how current trends in popular wellness culture toward &lsquo;sober curiosity&rsquo; (i.e., an interest in what reducing alcohol consumption would or could be like) and normalising non-drinking could increase women&rsquo;s preparedness to reduce alcohol consumption. Methods: Qualitative interviews were undertaken with 27 midlife Australian women (aged 45&ndash;64) living in Adelaide, Melbourne and Sydney in different social class groups (working, middle and affluent-class) to explore their perceptions of sober curiosity. Results: Women were unequally distributed across social-classes and accordingly the social-class analysis considered proportionally the volume of data at particular codes. Regardless, social-class patterns in women&rsquo;s preparedness to reduce alcohol consumption were generated through data analysis. Affluent women&rsquo;s preparedness to reduce alcohol consumption stemmed from a desire for self-regulation and to retain control; middle-class women&rsquo;s preparedness to reduce alcohol was part of performing civility and respectability and working-class women&rsquo;s preparedness to reduce alcohol was highly challenging. Options are provided for alcohol reduction targeting the social contexts of consumption (the things that lead midlife women to feel prepared to reduce drinking) according to levels of disadvantage. Conclusion: Our findings reinstate the importance of recognising social class in public health disease prevention; validating that socially determined factors which shape daily living also shape health outcomes and this results in inequities for women in the lowest class positions to reduce alcohol and related risks