Alcohol in transport: issues and interventions
Whilst the majority of the population in England consume alcohol within the Government's recommended limits (or not at all), an estimated 6.6 million people (20.1%) drink at hazardous levels and a further 1.55 million (5%) drink at harmful levels (NWPHO 2008).1 These higher levels of consumption are linked with a wide range of related harms including assaults (Anderson and Hungerford 2007; Hughes et al. 2007), anti-social behaviour (Harrington 2000), arguments (Morleo et al. 2008a), and accidents and injuries (Jones et al. 2008). More long-term negative consequences may also be attributable to excessive alcohol consumption including cancer, heart disease and liver cirrhosis (Jones et al. 2008). Such harms can have a devastating effect on the individual, family, community and society in general. In fact, alcohol misuse is estimated to cost the United Kingdom (UK) economy £20 billion per annum, including costs to the health service, criminal justice system and the economy (Strategy Unit 2003).Levels of alcohol consumption may be particularly high in specific settings such as nightlife venues (Hughes et al. 2008; Measham and Brain 2005), at sports events (De Jong 2007; IAS 1998; Wright 2006), and during the summer (Cho et al. 2001). Correspondingly, increased levels of harm may be experienced in these settings. Efficient transport mechanisms have been seen as a solution to some of the identified harms, as they can enable the effective dispersal of intoxicated individuals before issues arise, particularly within a nightlife setting (CLG 2004; Hughes et al. 2007; ICAP 2007; ODPM 2003).Whilst few transport provision interventions have been fully evaluated (Hughes et al. 2007), Manchester's night service has helped to reduce assaults (Brown undated cited in Hughes et al. 2007). However, whilst adequate provision of transport may ease frustrations, it does not reduce intoxication, and inevitably effective dispersal may move incidents rather than control them. Thus, it is important to ensure that late night transport provides a safe service for those travelling at times such as the end of licensing hours (as mentioned in the National Alcohol Strategy; DH et al. 2007). Because of such issues, the National Alcohol Strategy recommends that transport providers must work with local partners in order to provide safe night time transport (DH et al. 2007).The project, led by Risk Solutions and commissioned by the Rail Safety and Standards Board, was for researchers at the Centre for Public Health (CPH), Liverpool John Moores University (LJMU) to investigate the concerns outlined above, looking at both the relationship between alcohol misuse and potentially resulting problems that may occur in the rail environment, but also assessing how the rail industry can overcome such issues effectively and without unduly impacting on those who do drink but do not cause problems. To do this, this review has gone beyond the Great Britain (GB) rail environment to consider interventions in other transport contexts and elsewhere both within the UK and internationally. The literature review was undertaken as part of the rail industry's research and development programme, managed by RSSB, and funded by the UK Department for Transport.