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CHAPTER 7 Conclusions
7.1 Summary
The worth of the literature in this field is restricted by methodological flaws and reports failing to incorporate basic and consistent material suitable for meta- analytic review (Wagenaar et al, 1995). Furthermore, whilst there has been a reliance on US literature in some sections, these results must be interpreted with caution as they cannot necessarily be used as direct comparison to the UK. There is also some evidence of publication bias in US designs.
Similarly, across many initiatives in the UK there is a general lack of systematic evaluation of the effectiveness in terms of reducing alcohol related crime/disorder and antisocial behaviour (Reid- Howie Associates, 2003).
Evidence from a large body of research carried out in the UK and elsewhere has established that alcohol consumption is a significant contributory factor with respect to a range of offences, and in particular violence, disorder and antisocial behaviour. However, drinking alcohol is a popular activity associated with enjoyment and being sociable. These are the conflicting realities that make the issue very complex, and underline why work in this field needs to be carefully balanced. It is not alcohol consumption per se that is at issue; at issue are those circumstances and situations where the consumption of alcohol contributes to unacceptable forms of behaviour.
Difficulty arises when trying to discern where the groups involved in antisocial behaviour etc. obtain alcohol and what their subsequent behaviour is. Ultimately there is an overall paucity of studies in the area specifically looking at the relationship between antisocial/unwanted behaviour and off-licence sales.
7.1.1 Irresponsible selling
Examination of the cited studies demonstrates that selling to underage people in off-licences is prevalent. In addition, initial indications are that selling to those who are already intoxicated is also common. More work is necessary on the prevalence of selling to those already intoxicated in off-licences and the factors that may prevent or reduce selling.
Solutions to the problem of irresponsible selling need to be implemented or reinforced. The literature suggests that stronger enforcement of the law through regular checks and test purchasing, along with server training, ID schemes, and media coverage of these measures could help reduce the level of irresponsible selling (e.g. Holder, 2000; Grube, 1997; Huckle, 2005; Hopkinson and Humphreys, 2006). This checking and enforcing would presumably come under the remit of the proposed Liquor Licensing Standards Officers ( LLSOs), and/or the police. In addition Proof of Age and No Proof No Sale schemes should be reinforced.
7.1.2 Drinks promotions
Recent studies have shown that cheap drinks promotions in off-licences have an effect on alcohol consumption (e.g. Kuo et al, 2003). However, there seems to be some confusion on the part of UK alcohol industry related bodies as to whether off-sales alcohol promotions do present a problem (e.g. Portman Group, 2003; Northern Ireland Drinks Industry Group, 2005).
Alcohol policy groups in the UK need to clarify or update their position on off-sales alcohol promotions in order to present a clear message. More research is needed on the topic to provide a stronger evidence base. The initial evidence suggests that drinks promotions in off-sales could be curtailed to some degree (Kuo et al, 2003), although again, further research is required to make definitive recommendations.
Further investigation is also required into the impact of 'value' and 'own brand' alcohol brands to understand their share of the market, who is buying these products and what the effects are.
7.1.3 Targeted marketing
Alcopops, though generally perceived as targeting underage drinkers (and possibly do provide a more accessible introduction to alcohol), are not generally drunk to excess by young people due to their being too expensive, too weak and often perceived as too childish (e.g. Brain and Parker, 1997; Hughes et al 1997). Underage drinkers wanting to become intoxicated quickly and cheaply instead opt for cheaper, high alcohol, brands (e.g. Brain and Parker, 1997). By the time young people are closer to legal drinking age they generally drink conventional drinks which are not perceived as being aimed at young people (Hughes et al, 1997).
One suggestion requires pricing drinks by alcohol content (e.g. MacKintosh et al, 1997, Ponicki 1997) along with some restriction on off-sales drink promotions; this could prevent cheap access to high alcohol drinks. In addition there seems to be the suggestion that there should be more alcohol education offered at school (e.g. MacKintosh et al, 1997) as current substance education tends to focus on drugs (MacAskill et al, 2001). Finally, further research needs to be carried out on social sources of alcohol for young people and how these can be limited.
In addition there is some evidence from the US that advertising and pricing does target both minority ethnic and low income areas (Alaniz, 1998; Harwood et al, 2003). Responses at local level (e.g. Mack, 1997) appear to be helpful in preventing this.
7.1.4 Effects of off-licences on the community
Evidence suggests that the density of and even the very existence of off-sales outlets contributes to levels of assault (e.g. Stevenson et al, 1999), homicide (e.g. Scribner et al, 1997) and self reported injury rates (e.g. Treno et al, 2001). However, again the point must be made that the evidence is largely US based.
With regards to drink-driving and alcohol related crashes the evidence is mixed, with some studies showing off-sales related to a higher rate of such incidents and other studies showing off-sales as a potential preventive factor (e.g. Gruenewald, 1996; McCarthy, 2003). In addition there is a clear relationship in general between alcohol sales and disorder (e.g. Stevenson et al, 1999b).
Increased monitoring (as mentioned in section 7.1.1) would be beneficial in order to reduce the large contribution that young people and those already intoxicated make to these problems. In addition increased police drink driving checks would be helpful (e.g. Holder et al, 2000). Further alcohol/planning restrictions could be put in place such as laws relating to the distance between alcohol outlets and public places (Holder et al, 2000) along with further reinforcement of current public drinking and confiscation bylaws.
Finally, the area outside off-sales establishments could be made less desirable as a place to be through various environmental measures (e.g. Jackson, 2005; ACS/ BRC/ WSA, 2004), along with the introduction of new laws against loitering outside off-sales establishments (e.g. Swanson, 2004).
7.2 Overall Conclusions
The aim of this review was to examine the depth and range of information and evidence available with regards to off-sales and the effect promotions have on the selling of alcohol in the community.
It would be fair to say that as a whole, across the different sections of the literature, there are wide gaps in understanding of the intricacies of this subject. A large amount of research has been conducted on the selling of alcohol in pubs and clubs, along with a considerable amount of work on violence and disorder and the relationship with alcohol. However, investigations of the exact connections between where alcohol is purchased in the community setting and the effects are limited.
We know that promotion of alcohol does have an effect on consumption. There is evidence to suggest alcohol availability and affordability has increased over the last ten years and the work looking at alcopops in the 1980's and 90's is now, to a certain extent, out of date. What is still unclear is published evidence of the effects of promotions within the off-sales sector.
There is considerable evidence showing that irresponsible selling to youngsters does happen within the off-sales sector, however, again, the literature contradicts itself on the best solutions to this problem. Outlet density work is prominent in the US but less so in the UK, and issues such as front loading of alcohol through increased sales of alcohol via off-sales is not addressed within the formal literature. Obviously licensing laws within the UK have changed recently and it is too early to find within the literature any research conducted on the effects of these changes.
It seems from this brief literature trawl that the off-sales sector has been missed when researchers have been looking at key issues. There is no doubt that Scotland shows some of the highest levels of alcohol- related harm in Europe. However there is often a jump from the link between alcohol- related harm and anecdotal evidence of where the problems lie.
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