Evaluation of the Liverpool Drink Less Enjoy More intervention

In the UK it is an offence to knowingly sell alcohol to, or purchase alcohol for, a drunk person (Regulated under Section 141 and 142 of the Licensing Act 2003). However, until recent times public awareness, bar server compliance and police enforcement of this legislation has appeared to be low. Critically, UK nightlife environments are often characterised by high levels of intoxication and alcohol-related harms. Excessive alcohol use damages the public's health, while managing nightlife drunkenness and associated problems such as anti-social behaviour and violence places huge demands on police, local authorities and health services. To reduce such harms an extensive range of policies and interventions have been implemented at local and national levels including high profile policing, changes to licensing laws and environmental measures to improve safety. Whilst there is some evidence to indicate that these measures may contain and manage alcohol-related harms, they do little to reduce levels of intoxication or address harmful and pervasive cultures of nightlife drunkenness.A study conducted in Liverpool in 2013 found that 84% of alcohol purchase attempts by pseudo-intoxicated actors in pubs, bars and nightclubs were successful (i.e. alcohol was sold to the actor; Hughes et al., 2014). Studies conducted elsewhere have suggested that reductions in the service of alcohol to drunks, and associated harms, in nightlife settings can be achieved through the implementation of multi-component interventions that incorporate community mobilisation, enforcement of the laws around the service of alcohol to drunks and responsible bar server training. Thus to address the sale of alcohol to drunks in the city's nightlife, local partners developed and implemented the multi-component Say No To Drunks pilot intervention. The intervention aimed to: increase awareness of legislation preventing sales of alcohol to drunks; support bar staff compliance with the law; provide a strong deterrence to selling alcohol to drunks; and promote responsible drinking amongst nightlife users. Following an evaluation of Say No To Drunks, the intervention was further refined, broadened and implemented as a second phase in 2015 - rebranded to Drink Less Enjoy More. To inform the continued development of the intervention, the Centre for Public Health at Liverpool John Moores University was commissioned to evaluate the intervention, comparing the results to previous work.ConclusionPrevious studies have suggested that multi-component community based interventions can have a significant effect on reducing the over service of alcohol to drunk people and subsequent alcohol-related harms in nightlife settings. The Drink Less Enjoy More intervention implemented in Liverpool City Centre is one of the first of its kind in England, aiming to address the over service of alcohol to drunks following this evidenced based multicomponent approach. Findings from the intervention evaluation are extremely positive, suggesting that since Drink Less Enjoy More was implemented, nightlife user and bar staff knowledge of the laws around the service of alcohol to drunks has significantly increased, and crucially the service of alcohol to pseudo-intoxicated actors has reduced substantially. Learning from the pilot phase and subsequent amendments to the intervention, and a greater commitment to implementing all aspects of the intervention, has served to strengthen the intervention's impact. Although wider impacts on addressing the culture of drunkenness in Liverpool's nightlife were not observed, it is important that this intervention is recognised as a crucial step in a developing body of work to prevent sales of alcohol to drunks. Importantly, this work is helping create safer and healthier nightlife environments in Liverpool, and elsewhere across the UK.