At a glance
Alcohol consumption can cause violent behaviour and related injuries. Subsequently, on premise alcohol sales (i.e. bars) may induce or reinforce such behaviour. This rationale suggests that regulating opening hours of pubs and bars could have an effect on violent behaviour. Restrictions in closing hours for on premise alcohol sales might reduce levels of violence in a delineated area.
Policies for regulating opening hours of on-premise alcohol sales are hypothesised to decrease levels of alcohol-related violence and injuries based on the availability theory. The core thesis of availability theory is that “the greater the availability of alcohol in a society, the greater the prevalence and severity of alcohol-related problems” (Single, 1988, p. 329 in Tesch & Hohendorf 2018). The basic mechanism is that higher alcohol availability leads to higher mean levels of consumption and thus to higher levels of moderate and heavy drinking which in turn produce more alcohol-related problems including violence and injury.
The prevalence of violence in or around on premise alcohol sales as well as alcohol-related injury is however influenced by a variety of individual and environmental factors that should be considered both in the implementation of regulations as well as in the evaluation of such strategies. The implementer should consider differential effects for varying subpopulations (e.g. men, individuals aged 25–34 years in the case of alcohol-related injuries, in De Goeij et al. see below) and match the regulations to local needs. Such regulations may additionally have harmful or iatrogenic effects such as displacement of assault and injury to other districts, to the private sphere, or peak prevalence caused by uniform closing hour regulations.
Subsequently, it is advisable to integrate such regulations in multicomponent environmental strategies that consider local environmental as well as individual risk variations and needs. Regulations can for instance be incorporated in broader environmental approaches that also include preventive activities such as training for staff of licensed premises, such as the ‘STAD’ project (Stockholm prevents alcohol and drug problems).
Overview of results from the European studies
The effect of changing bar closing hours have been studied in experimental evaluation designs in Norway (Rossow et al. 2012) and The Netherlands (De Goeij et al., 2012). Conducting an RCT is not possible because of the environmental nature of these measures.
Rossow and colleagues (2012) estimated the effect on violence of small changes in closing hours for on-premise alcohol sales and assessed whether a possible effect is symmetrical. The study demonstrated that each additional 1-hour extension to the opening times of premises selling alcohol was associated with a 16% increase in violent crime. The quasi-experimental evaluation study drew on data from 18 Norwegian cities that extended or restricted the closing hours for on-premise alcohol sales with a maximum of 2 hours. Closing hours were measured in terms of the latest permitted hour of on-premise trading, ranging from 1 a.m. to 3 a.m. The outcome measure comprised police-reported assaults that occurred in the city centre between 10 p.m. and 5 a.m. at weekends. Assaults outside the city centre during the same time window functioned both as a proxy for potential confounders and as a control variable. The data spanned a period of ten years (2000–2010) and included 774 observations. Outcomes from the main analyses suggested that each 1-hour extension of closing hours was associated with a statistically significant increase of 4.8 assaults (95% CI 2.60, 6.99) per 100 000 inhabitants per quarter (i.e. an increase of about 16%). Findings indicate that the effect is symmetrical (extending or restricting). These findings were consistent across three different modelling techniques.
De Goeij and colleagues (2015) studied the implementation of a new alcohol policy in Amsterdam allowing alcohol outlets in two of the five nightlife areas to extend their closing times from 1 April 2009 onwards. The study found that a 1-hour extension of alcohol outlet closing times in some of Amsterdam’s nightlife areas was associated with 34% more alcohol-related injuries. They investigated how levels and trends of hospital reported alcohol-related injuries changed after implementation of this alcohol policy by comparing areas with extended closing times to those without. A before-and-after evaluation compared changes in alcohol-related injuries between intervention and control areas. Participant alcohol-related ambulance attendances were compared between control and intervention areas between 1 April 2006 and 1 April 2009 (respectively n=544 and n=499) and between 1 April 2009 and 1 April 2011 (respectively, n=357 and n=480). The results demonstrate that after 1 April 2009, intervention areas showed a larger change in the level of alcohol-related injuries than control areas [incidence rate ratio 1.34, 95% confidence interval (CI) =1.12, 1.61], but trends remained stable in all areas. This increase was only statistically significant for the following subgroups: 2.00–5.59 a.m., weekend days, men, individuals aged 25–34 years, and people transported to a hospital. However, the increase did not differ between subgroups with statistical significance.
Countries where evaluated
Description of programme
In Norway, trading hours (for both on-premise and off-premise alcohol sales) are decided at the municipality level, yet within national maximum trading hours. The national ‘normal closing hours’ for on-premise sales are 12 midnight for spirits and 1 a.m. for beer/wine, and the ‘maximum closing hours’ are 3 a.m. for all types of alcoholic beverages. Patrons are, by national law, allowed to consume alcohol 30 minutes after the closing hours for sales. The municipalities may decide to extend or restrict closing hours as long as they are within the national ‘maximum closing hours’. Over the past decade many Norwegian municipalities have changed—extended or restricted—the closing hours for on-premise sales, but the changes have been relatively minor, typically less than 2 hours. However, each additional 1-hour extension to the opening times of premises selling alcohol was associated with an increase in violent crime. (Rossow et al. 2012)
In the Netherlands, Amsterdam implemented a new alcohol policy allowing alcohol outlets in two of the five nightlife areas to extend their closing times from 1 April 2009 onwards. A 1-hour extension of alcohol outlet closing times in some of Amsterdam’s nightlife areas was associated with more alcohol-related injuries. (De Goeij et al. 2015)