Local alcohol policies Introduction



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  • Density

General


Babor T, et al. 2010. Alcohol: No Ordinary Commodity Research and Public Policy (2nd ed.). Oxford: Oxford University Press.

New Zealand Law Commission 2010. Alcohol in our lives: curbing the harm.


Location


Hill L. 2004 Planning for the sale of alcohol : an issues paper for the Ministry of Health. Report [344.9713 HIL] Wellington, N.Z. : Ministry of Health, 2004. 0478282125 Accessed at:

http://www.ndp.govt.nz/moh.nsf/indexcm/ndp-publications-planningsalealcohol?Open



The aim of this paper is to contribute to debate and strategic thinking about local alcohol licensing and planning issues as local governments consult their communities and develop their long term Council Community Plans. It explores issues and opportunities in planning for licensed premises that may contribute to the reduction of local alcohol-related harm.

Truong K, Sturm R. 2009. ‘Alcohol environments and disparities in exposure associated with adolescent drinking in California’. American Journal of Public Health 2009 Feb; 99(2) : 264-270. Accessed at: http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=36300998&site=ehost-live



Alcohol outlets are concentrated in disadvantaged neighborhoods and can contribute to adolescent drinking. To reduce underage drinking, environmental interventions need to curb opportunities for youth to obtain alcohol from commercial sources by tightening licensure, enforcing minimum-age drinking laws, or other measures.

Berke E, et al. 2010. ‘Alcohol retail density and demographic predictors of health disparities : a geographic analysis’ American Journal of Public Health 2010 Oct; 100(10) ; 1967-1971. Accessed at http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=53724892&site=ehost-live



Greater density of alcohol retailers was associated with higher levels of poverty and with higher proportions of Blacks and Latinos in urban census tracts. These disparities could contribute to higher morbidity in these geographic areas.

Day P, Breetzke G, Kingham S, & Campbell M. 2012, ‘Close proximity to alcohol outlets is associated with increased serious violent crime’. New Zealand Australian and New Zealand Journal of Public Health 2012 Feb; 36(1) : 48-54



Having greater geographic access to alcohol outlets was associated with increased levels of serious violent offending across study areas.

Wilkinson C, & Livingston M. 2012. ‘Distances to on- and off-premise alcohol outlets and experiences of alcohol-related amenity problems’ Drug and Alcohol Review 2012 Jun; 31(4) : 394-401



This paper examines the association between the proximity of someone's home to alcohol outlets and their experience of public amenity problems. A possible interpretation of the results is that respondents living close to on- and off-premise outlets experience more amenity problems than those living further away, but that these experiences are concentrated among demographic groups who live in these areas. Direction of influence cannot be inferred from these cross-sectional findings.

Chilenski S, 2010. ‘From the Macro to the Micro: A Geographic Examination of the Community Context and Early Adolescent Problem Behaviors’. American Journal of Community Psychology, Dec2011, Vol. 48 Issue 3/4, p352-364.



Results demonstrated that the number of alcohol and tobacco retail locations within a one-mile radius of each adolescent's home positively associated with student-reported problem behaviors above and beyond the influence of school district and individual characteristics.

Halonen Jet al. 2013. ‘Living in proximity of a bar and risky alcohol behaviours : a longitudinal study.’ Addiction 2013 Feb; 108(2) : 320-328.



Moving place of residence close to, or far from, a bar appears to be associated with a small corresponding increase or decrease in risky alcohol behaviour.

Pearce J, Day P, Witten K. 2008. ‘Neighbourhood provision of food and alcohol retailing and social deprivation in urban New Zealand’. Urban policy and research 2008 Jun; 26(2) : 213-227. Accessed at:


http://www.tandfonline.com/doi/abs/10.1080/08111140701697610

The association between food retail and licensed alcohol outlet locations was examined against deprivation for urban neighbourhoods across New Zealand. A range of retail options tended to be better in more deprived neighbourhoods.

Wechsler H. et al 2002. ‘Secondhand effects of student alcohol use reported by neighbors of colleges: the role of alcohol outlets’. Social Science & Medicine: Volume 55, Issue 3, August 2002, Pages 425–435



The results suggest that neighborhood disruptions around colleges due to heavy alcohol use may be reduced by limiting the presence of alcohol outlets in those areas, and the marketing practices that this engenders.

Ashe M, Jernigan D, Kline R, Galaz R. 2003. ‘Land Use Planning and the Control of Alcohol, Tobacco, Firearms, and Fast Food Restaurants’. American Journal of Public Health: September 2003, Vol. 93, No. 9, pp. 1404-1408.



We found that land use regulations are a public health advocacy tool that has been successfully used to lessen the negative effects of alcohol retail outlets in neighborhoods. More research is needed to determine whether such regulations are successful in reducing the negative effects of other retail outlets on community health.

Density


Campbell C, et al. 2009. ‘The Effectiveness of Limiting Alcohol Outlet Density As a Means of Reducing Excessive Alcohol Consumption and Alcohol-Related Harms’ American Journal of Preventive Medicine: Volume 37, Issue 6, December 2009, Pages 556–569

Most of the studies included in this review found that greater outlet density is associated with increased alcohol consumption and related harms, including medical harms, injury, crime, and violence. Primary evidence was supported by secondary evidence from correlational studies. The regulation of alcohol outlet density may be a useful public health tool for the reduction of excessive alcohol consumption and related harms.

LIANG W, CHIKRITZHS T. 2011. ‘Revealing the link between licensed outlets and violence: Counting venues versus measuring alcohol availability’. Drug and Alcohol Review: 30: 524–535. doi: 10.1111/j.1465-3362.2010.00281.x



The link between on-site outlets and violence may be primarily underpinned by negative amenity effects while off-site outlet effects occur via increased availability. Alcohol sales volumes from off-site outlets influence levels of violence, which occur at both licensed and residential settings. The substantial and wide-ranging effects of liquor stores on alcohol-related harms may have been underestimated in the literature and by policy makers

Livingston M, Chikritzhs T, Room R. 2007. ‘Changing the density of alcohol outlets to reduce alcohol-related Problems’. Drug and Alcohol Review : 26, 557 – 566.



In this Harm Reduction Digest Livingston, Chikritzhs and Room review the research literature on the effects of density of alcohol sales outlets on alcohol consumption and alcohol-related problems; suggest a new way of conceptualising the relationships; and discuss the implications for reducing alcohol-related harm.

Livingston, M. 2008. ‘Alcohol outlet density and assault: a spatial analysis’. Addiction: 103: 619–628. doi: 10.1111/j.1360-0443.2008.02136.x



The study finds positive relationships between outlet density and assault rates and provides evidence that this relationship is non-linear and thus has critical values at which licensing policy-makers can impose density limits.

Stockwell T, Gruenewald P. (2004) ‘Controls on the physical availability of alcohol’. In: Heather N, Stockwell T, eds. The essential handbook of treatment and prevention of alcohol problems. Chichester: Wiley and Sons, 2004:213 – 33.



Reviews the evidence regarding the circumstances under which changes in the physical availability of alcohol achieved through changes in the legal drinking age, outlet densities, and trading hours can affect high risk drinking and alcohol related harm.

Chen M, Grube J, Gruenewald P. 2010. ‘Community alcohol outlet density and underage drinking’. Addiction, 105: 270–278. doi: 10.1111/j.1360-0443.2009.02772.x



Alcohol outlet density may play a significant role in initiation of underage drinking during early teenage, especially when youths have limited mobility. Youth who reside in areas with low alcohol outlet density may overcome geographic constraints through social networks that increase their mobility and the ability to seek alcohol and drinking opportunities beyond the local community.

McKinney C, Caetano R, Harris T, Ebama M. 2009. ‘Alcohol Availability and Intimate Partner Violence Among US Couples’. Alcoholism: Clinical and Experimental Research, 33: 169–176. doi: 10.1111/j.1530-0277.2008.00825.x



We found that as alcohol outlet density increases so does the risk of MFPV and that this relationship may differ for couples who do and do not report alcohol-related problems. Given that MFPV accounts for the majority of injuries related to intimate partner violence, policy makers may wish to carefully consider the potential benefit of limiting alcohol outlet density to reduce MFPV and its adverse consequences.

Kypri K, Bell M, Hay G, Baxter J. 2008. ‘Alcohol outlet density and university student drinking: a national study’. Addiction: 103: 1131–1138. doi: 10.1111/j.1360-0443.2008.02239.x



There are positive associations between alcohol outlet density and individual drinking and related problems. Associations remain after controlling for demographic variables and pre-university drinking, i.e. the associations are unlikely to be due to self-selection effects. Increasing alcohol outlet density, and particularly off-licences, may increase alcohol-related harm among university students.

Connor J, Kypri K, Bell M, Cousins K. 2011. ‘Alcohol outlet density, levels of drinking and alcohol-related harm in New Zealand: a national study.’ J Epidemiology Community Health 2011;65:841-846 doi:10.1136/jech.2009.104935



The positive associations seen between alcohol outlet density and both individual level binge drinking and alcohol-related problems appear to be independent of individual and neighbourhood SES. Reducing density of alcohol outlets may reduce alcohol-related harm among those who live nearby.

Gruenewald P. 2007. ‘The spatial ecology of alcohol problems: niche theory and assortative drinking’. Addiction, 102: 870–878. doi: 10.1111/j.1360-0443.2007.01856.x



The proposed mechanism is very general, and suggests that over-concentrations of outlets will lead to stratification of drinking groups and intensification of problems related to those outlets.

Kavanagh A, et al. 2011. ‘Access to alcohol outlets and harmful alcohol consumption: a multi-level study in Melbourne, Australia’. Addiction: 106: 1772–1779. doi: 10.1111/j.1360-0443.2011.03510.x



The number of off-premises alcohol outlets in a locality is associated with the level of harmful alcohol consumption in that area. Reducing the number of off-premises alcohol outlets could reduce levels of harmful alcohol consumption.

Livingston M. 2008, ‘A Longitudinal Analysis of Alcohol Outlet Density and Assault’. Alcoholism: Clinical and Experimental Research: 32: 1074–1079. doi: 10.1111/j.1530-0277.2008.00669.x



Changes in the number of alcohol outlets in a community are linked to changes in the amount of violence the community experiences. This relationship varies across the clusters of suburbs examined, with packaged liquor outlets consistently associated with violence in suburban areas and general (hotel) and on-premise (nightclubs, restaurants, and bars) licenses associated with violence in inner-city and inner-suburban areas.

Hay G, Whigham P, Kypri K, Langley J. 2009. ‘Neighbourhood deprivation and access to alcohol outlets: A national study’ Health & Place: Volume 15, Issue 4, December 2009, Pages 1086–1093



Strong associations were found between proximity to the nearest alcohol outlet and deprivation, there being greater access to outlets in more-deprived urban areas.

Pereira G, Wood L, Foster S, Haggar F. 2013. ‘Access to Alcohol Outlets, Alcohol Consumption and Mental Health’. PLoS ONE 8(1): e53461. doi:10.1371/journal.pone.0053461



We observed strong evidence for a small association between residential exposure to liquor stores and harmful consumption of alcohol, and some support for a moderate-sized effect on hospital contacts for anxiety, stress, and depression.

Cameron M, Cochrane W, McNeill K, Melbourne P, Morrison S, Robertson N. 2012. ‘Alcohol outlet density is related to police events and motor vehicle accidents in Manukau City, New Zealand’. Australian and New Zealand Journal of Public Health, 36: 537–542. doi: 10.1111/j.1753-6405.2012.00935.x



The results do not imply causality. However, they are broadly consistent with availability theory, and imply that local alcohol policy should account for the effects of additional outlets when new licences are granted. While the methodological approach described here is easily transferable to investigate the relationships elsewhere, we suggest some areas for improvement of future studies.

Cameron MP, Cochrane W, Gordon C, Livingston M. 2013. The locally-specific impacts of alcohol outlet density in the North Island of New Zealand, 2006-2011. Research report commissioned by the Health Promotion Agency. Wellington. Health Promotion Agency.



In global terms, bar and nightclub density appears to have the most robust and largest effects, being significantly positively associated with all categories of police event and with motor vehicle accidents. Supermarket and grocery store density generally has statistically significant and positive effects on police events, but this is significantly negatively related to motor-vehicle accidents. Licensed club density and other on-licence density are significantly positively related to many of the categories of police event. Locally, there is great variability across the North Island which demonstrates the need for locally specific policy development.

Huckle T, Huakau J, Sweetsur P, Otto H, Casswell S. 2008. ‘Density of alcohol outlets and teenage drinking: living in an alcogenic environment is associated with higher consumption in a metropolitan setting’. Addiction, 103, 1614-1621.



Alcohol outlet density was associated with quantities consumed among teenage drinkers in this study, as was neighbourhood deprivation. Supply by family, friends and others also predicted quantities consumed among underage drinkers and both social supply and self-reported purchase were associated with frequency of drinking and drunkenness. The ethnic status of young people also had an effect on consumption.

Matheson A. 2005. Alcohol in Auckland: Reducing associated harm. Auckland: Auckland Regional Public Health Service. Full report- http://www.arphs.govt.nz/Portals/0/Health%20Information/Alcohol%20and%20Tobacco/Liquor%20Licensing/Alcohol%20in%20Akld.reslo.pdf



This report summarises literature in relation to a range of possible strategies on order to guide the direction of internal policy and service development in relation to reducing alcohol-related harm.

Livingston M. 2011. Alcohol outlet density and harm: comparing the impacts on violence and chronic harms. Drug and Alcohol Review; 30(5), 515-523. Abstract- http://onlinelibrary.wiley.com/doi/10.1111/j.1465-3362.2010.00251.x/abstract



The density of alcohol outlets where the main activity is alcohol consumption (i.e. pubs) is positively related to rates of assault-related hospital admissions, while the density of off-premise alcohol outlets is related to the rate of alcohol use disorders.

Livingston M. 2011. A longitudinal analysis of alcohol outlet density and domestic violence. Addiction; 106(5), 919-925. Submitted full article- http://www.nabca.org/News/Files/Outlet%20Density%20and%20Domestic%20Violence.pdf



Alcohol outlet density was significantly associated with rates of domestic violence, over time. In particular, the density of hotel (pub) licences and the density of packaged liquor licences were positively related to domestic violence rates and the density of on-premise licences was negatively related to domestic violence.

Treno AJ, et al. 2007. The impact of outlet densities on alcohol-related crashes: A spatial panel approach. Accident Analysis and Prevention; 39(5),894-901. Abstract- http://www.ncbi.nlm.nih.gov/pubmed/17275773



Changes in numbers of licensed alcohol retail establishments, especially bars and off-premise outlets, affect rates of car crashes and related injuries.

Burgess M, Moffatt S. 2011. The association between alcohol outlet density and assaults on and around licensed premised. Crime and Justice Bulletin; 147. NSW: NSW Bureau of Crime Statistics and Research. Full report- http://www.lawlink.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/cjb147.pdf/$file/cjb147.pdf



Assaults were found to be highly concentrated around licensed premises. Limiting the density of alcohol outlets may help limit the incidence of assault.

Fone D, et al. 2012. Change in alcohol outlet density and alcohol-related harm to population health. BMC Public Health; 12, 428. Open access- http://www.biomedcentral.com/content/pdf/1471-2458-12-428.pdf



This paper describes the methodology for investigating the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community.

Alcohol Concern. 2011. One on every corner- the relationship between off-licence density and alcohol harms in young people. London. Full report- http://www.alcoholconcern.org.uk/assets/files/Publications/one-on-every-corner.pdf



The current availability of alcohol shapes the risk a young person faces as they grow up. One in ten alcohol specific hospital admissions - such as alcohol poisoning - may be attributable to the density of off-licensed premises locally. Relying simply on better enforcement of regulation banning the sale of alcohol to minors may not therefore be enough protection as young people access alcohol through the home, friends and family. It is likely to be the greater general availability of alcohol, attributable to local off-licence density that has a direct impact on the risks of harm that a young person faces.

Young R, Macdonald L, Ellaway A. 2013. Associations between proximity and density of local alcohol outlets and alcohol use among Scottish adolescents. Health & Place; 19(4), 124-130. Full article-http://www.google.co.nz/url?sa=t&rct=j&q=changing%20the%20density%20of%20alcohol%20outlets%20to%20reduce&source=web&cd=21&cad=rja&ved=0CC0QFjAAOBQ&url=http%3A%2F%2Fwww.alcohol-focus-scotland.org.uk%2Fview%2Fdownload%2F320-drinking-and-proximity-to-alcohol-outlets&ei=LHM2UZGNJM2UiAeJrIDQCA&usg=AFQjCNErgPye6IPKUM_kOjhCXf02FN5GNg&bvm=bv.43148975,d.dGY



Proximity and density of on-premise outlets were not associated with weekly drinking. However, adolescents living close (within200m) to an off- sales outlet were more likely to drink frequently (OR1.97, p¼0.004), as were adolescents living in areas with many nearby off-premises outlets (OR1.60, p¼0.016). Our findings suggest that certain alcohol behaviours (eg, binge drinking) may be linked to the characteristics of alcohol outlets in the vicinity.

Lipton R, Gruenewald PJ. 2002. The spatial dynamics of violence and alcohol outlets. Alcohol; 63 (2), 187-195. Abstract- http://www.ncbi.nlm.nih.gov/pubmed/12033695



The density of bars was found to be strongly associated with greater rates of assault, while density of restaurants was associated with less violence. Both appeared to have greatest effect in densely populated areas. Local and nearby population characteristics were also found to be related to greater rates of violence. The study suggests that alcohol outlets, in the presence of socioeconomic measures, moderate the occurrence of violence in urban areas.

Stockwell T, et al. 2011. Impact on alcohol-related mortality of a rapid rise in the density of private liquor outlets in British Columbia: a local area multi-level analysis. Addiction; 106(4), 768-776. Abstract- http://www.ncbi.nlm.nih.gov/pubmed/21244541



The total number of liquor stores per 1000 residents was associated significantly and positively with population rates of alcohol-related death. A conservative estimate is that rates of alcohol-related death increased by 3.25% for each 20% increase in private store density. The percentage of liquor stores in private ownership was also associated independently with local rates of alcohol-related death after controlling for overall liquor store density. Alternative models confirmed significant relationships between changes in private store density and mortality over time. The rapidly rising densities of private liquor stores in British Columbia from 2003 to 2008 was associated with a significant local-area increase in rates of alcohol-related death.

AlcoholNZ. Health Promotion Agency October 2012. Available at: http://www.alac.org.nz/alcoholnz-october-2012-issue-available

This issue contains articles on outlet density and availability.

ALAC. 2012. The impacts of liquor outlets in Manukau City – Summary Report revised Accessed at: http://www.alac.org.nz/sites/default/files/research-publications/pdfs/ManukauReportSummaryREVISED.PDF



In Manukau City, off-licence liquor outlets tend to be located in areas of high social deprivation and high population density, while on-licence liquor outlets tend to be located in main centres and areas of high amenity value. Higher off-licence density is associated with lower alcohol prices and longer opening hours. The density of both off-licence and on-licence liquor outlets is associated with a range of social harms, including various police events and motor vehicle accidents. However, these results are context specific and care should be taken in applying them to other locations.

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