Abstract
Alcohol sales to intoxicated patrons are illegal and may lead to public health issues such as traffic crashes and violence. Over the past several decades, considerable effort has been made to reduce alcohol sales to underage persons but less attention has been given to the issue of sales to obviously intoxicated patrons. Studies have found a high likelihood of sales to obviously intoxicated patrons (i.e., overservice), but little is known about efforts by enforcement agencies to reduce these sales. We conducted a survey of statewide alcohol enforcement agencies and local law enforcement agencies across the U.S. to assess their strategies for enforcing laws prohibiting alcohol sales to intoxicated patrons at licensed alcohol establishments. We randomly sampled 1,631 local agencies (1082 participated), and surveyed all 49 statewide agencies that conduct alcohol enforcement. Sales to obviously intoxicated patrons were reported to be somewhat or very common in their jurisdiction by 55% of local agencies and 90% of state agencies. Twenty percent of local and 60% of state agencies reported conducting enforcement efforts to reduce sales to obviously intoxicated patrons in the past year. Among these agencies, fewer than half used specific enforcement strategies on at least a monthly basis to prevent overservice of alcohol. Among local agencies, enforcement efforts were more common among agencies that had a full-time officer specifically assigned to carry out alcohol enforcement efforts. Enforcement of laws prohibiting alcohol sales to obviously intoxicated patrons is an underutilized strategy to reduce alcohol-related problems, especially among local law enforcement agencies.
Keywords: alcohol, enforcement, overservice, sales to intoxicated patrons
Introduction
A myriad of approaches have been employed to reduce the harms related to alcohol use among youth and the population as a whole. Among these are efforts to enforce laws to prevent and reduce illegal sales of alcohol at bars, restaurants, and other commercial alcohol serving venues. Two types of alcohol sales are illegal in most jurisdictions in the U.S.—sales to persons under the legal drinking age (<age 21 in U.S.) and sales to obviously intoxicated patrons (also referred to as “overservice” of alcohol).
Considerable attention and effort has been directed over the past several decades in the U.S. toward increasing enforcement related to alcohol sales to underage persons [1]. However, less attention has been paid to the issue of alcohol sales to obviously intoxicated patrons, despite research that shows a high likelihood of these types of illegal alcohol sales [2–8]. The likelihood of sales to obviously intoxicated persons has been assessed through purchase attempts by pseudo-intoxicated patrons—adults actors (≥ age 21) who feign intoxication while attempting to purchase alcohol. Freisthler et al. [3] found that among 135 purchase attempts at bars and restaurants in California, the actors were able to purchase alcohol in 58% of their attempts. Using similar methodology, studies conducted in the Midwestern U.S. found a 62% purchase rate at bars [6], 65–79% purchase rates at bars and restaurants [4, 7], and a 83% purchase rate at off-premise (e.g., liquor stores, grocery stores) establishments [7]. Similar rates have been seen in Europe and Australia [2, 5, 8].
Selling alcohol to obviously intoxicated patrons contributes to excessive consumption and can lead to public health problems such as motor vehicle crashes, assaults, and other violent crime [9]. One U.S. study found that among adults who reported binge drinking (consuming 5+ drinks on one occasion) about one-third had their most recent binge drinking episode at a bar or restaurant, and approximately 20% of those who binge drank at a bar or restaurant reported driving after that binge drinking episode [10]. Numerous studies have documented that assaults and other violence are often linked to alcohol use in general, and with excessive consumption at bars and clubs in particular [11–14].
Despite the high propensity for sales to intoxicated patrons and the documented harms associated with excessive consumption, little is known about what proportion of state or local law enforcement agencies are using strategies to reduce rates of alcohol sales to obviously intoxicated patrons. Although an agency’s funds and resources may be limited, enforcement of overservice laws could be a sensible strategy given that many serious and less serious types of crime are associated with alcohol use (e.g., assaults, vandalism). One report from the National Highway Traffic Safety Administration suggests that, based on in-depth interviews with alcohol beverage control agents in 10 states, enforcement efforts aimed at sales to intoxicated patrons are rare [15]. However, there has not been a national-level survey of local and state law enforcement agencies to assess the actual prevalence of enforcement efforts targeting overservice of alcohol.
Additionally, researchers have not assessed what types of enforcement efforts are most commonly used by agencies to attempt to prevent sales to obviously intoxicated patrons. Currently, a best practice for enforcement targeting sales to obviously intoxicated patrons has not been identified. Enforcement strategies that may be used but that are not specific to overservice involve enforcement agents conducting brief visits at establishments (i.e., walk-throughs, random inspections) to detect violations of laws, including selling alcohol to a patron who is obviously intoxicated. One type of enforcement effort specific to overservice involves undercover law enforcement agents conducting lengthy observations at alcohol establishments to observe whether the establishment makes illegal sales to obviously intoxicated patrons. However, these observations may be fairly time consuming and the research evidence for this approach is not conclusive [16–17]. Another enforcement strategy that may also be specific to overservice issues is testing of patron’s blood alcohol content (BAC) to determine if the patron is impaired by alcohol (which may be useful in jurisdictions that allow BAC readings as evidence in proving overservice). Finally, enforcement agencies may use educational approaches to address sales to obviously intoxicated patrons, such as pseudo-intoxicated purchase attempts followed up with feedback to retail establishments about the results of these attempts.
In this study, we conducted a survey of local law enforcement agencies and statewide alcohol enforcement agencies across the U.S. to assess whether they are addressing alcohol sales to intoxicated patrons at licensed alcohol establishments, and if so, what types of actions they are taking. We also assessed whether certain agency and jurisdiction characteristics are associated with the likelihood of conducting overservice enforcement. In addition, we examined the levels of combined overservice enforcement across local and state agencies. Some states may conduct overservice enforcement at both state and local levels; in others, enforcement may be primarily designated to one of the levels. Our results provide the first comprehensive assessment of the efforts among local and state enforcement agents to reduce and prevent overservice of alcohol.
Materials and Methods
Data were collected for this study as part of a larger study assessing the associations between state alcohol policies and various alcohol-related outcomes in the U.S. As part of this larger study, we are attempting to construct a comprehensive measure of alcohol law enforcement (combined local- and state-level enforcement) for each of the 50 states. To this end, we conducted surveys of a stratified random sample of local law enforcement agencies and a census of statewide alcohol enforcement agencies in 2010–2011 regarding their alcohol enforcement efforts. This study was approved by the Institutional Review Board at the University of Minnesota.
Local law enforcement agencies
We used a multi-stage strategy to select local law enforcement agencies using a list of 15,833 municipal and county agencies from the U.S. Department of Justice Bureau of Justice Statistics (available from http://bjs.ojp.usdoj.gov/content/pub/pdf/csllea04.pdf) for 2004 (the most recent list available at time of survey). First, we divided the 50 states into 25 large states and 25 small states based on the number of agencies in the state (median = 300 agencies). Hawaii had only four agencies so we included all four in our sample. For the other 49 states, we sampled within each state based on the proportion of county sheriff versus municipal police and ensuring equal numbers of small and large agencies (using median number of officers per agency). We selected 20 agencies in small states and 40 agencies in large states for a total of 1,484 agencies (4 + 24×20 + 25×40). Additionally, Texas has a unique type of law enforcement agency called “constables”. We randomly selected 20 of the 512 constable agencies bringing our sample to 1,504 agencies. Finally, given that this sampling strategy did not necessarily capture agencies in the largest cities (which tend to account for a high percentage of a state’s population), we added the municipal police agency from the three largest cities in each state if these agencies were not already in our sample (n=127). Our final sample consisted of 1,631 law enforcement agencies.
State agencies
We created a list of state agencies and contacts that conduct alcohol enforcement in the U.S. by consulting with multiple organizations, including the National Association of Alcohol Beverage Control Agencies (NABCA) and the National Liquor Law Enforcement Association (NLLEA). We excluded Hawaii because it has four county-level agencies rather than a statewide agency for alcohol enforcement. In 46 states, we surveyed a representative from a state alcohol beverage control agency or similar organization or department (e.g., liquor control division; alcohol & tobacco commission). The remaining three states had special circumstances. In Nevada and Maryland, alcohol enforcement is primarily conducted at the local level [15] but each has a statewide agency that conducts some alcohol enforcement as a secondary role—Nevada’s State Department of Taxation and Maryland’s State Comptroller—which we included in this study. In Pennsylvania, we surveyed the State Police department rather than an alcohol beverage control agency because the police department handles alcohol enforcement in that state. Our final sample included 49 statewide agencies.
Survey administration
At each agency, we attempted to survey the agent/officer most knowledgeable about the agency’s enforcement activities pertaining to alcohol-related laws. We identified potential respondents through recommendations from leaders at NABCA and NLLEA, agency websites, through telephone calls to the agencies, and via Internet searches. We then contacted each identified respondent via telephone to determine if he/she was indeed the person most knowledgeable about the agency’s alcohol enforcement activities; if not, we asked for referrals to the appropriate person until that person was identified.
We initially conducted the surveys via the telephone. The telephone surveys were administered by trained research staff who entered survey responses into an online data collection form. For the local agency survey, our protocol was to make up to 10 calls per agency; however, in states where after 10 calls less than 50% of local agencies in that state had participated we made additional calls as needed to reach a minimum of 50% of agencies in the state. For the state survey, we made an average of 5–6 calls per agency (with a maximum of 30 attempted calls per agency). If requested by the respondent, we provided the option of completing the survey online (survey link was sent via email; 47% of participants from local agencies and 53% of participants from state agencies completed the survey online). In addition, 10 local agencies and one state agency completed the survey by regular mail or fax—these data were entered into our online data collection form by our research staff. Data were housed on a secure server and were maintained according to industry standards for Internet security and standards for research protection established by the University of Minnesota’s Institutional Review Board.
Response rates
The overall response rate for the local law enforcement survey was 66.3% (1082/1631), with a range from 50% to 86% per state. Local agencies that did not respond to our survey were not significantly different (Chi-square tests; α = 0.05) from agencies that did respond in terms of agency type, number of agencies in the state, number of officers per 1000 residents, proportion of residents living in poverty, or the proportion of Black residents in the jurisdiction; however, agencies in smaller jurisdictions (population < 10,000) and agencies in jurisdictions with a lower proportion of Hispanic residents (< 3%) were less likely to respond. For the state agency survey, our response rate was 100% (49/49).
Measures
Our outcome measure assessed whether or not the agency conducted enforcement actions to address sales to intoxicated patrons. The survey question used for this measure was: Has your agency conducted enforcement efforts targeting sales to obviously intoxicated patrons at licensed alcohol establishments? Response options for this question were “yes”, “no”, “don’t know”, or “we do not have the authority to enforce laws pertaining to sales to obviously intoxicated patrons”; for analyses we dichotomized this to “yes” vs. “no” (“don’t know” and “we do not have the authority…” were treated as missing). Although some states may not have specific statutes prohibiting sales to intoxicated patrons, we asked all survey respondents about their enforcement of alcohol overservice to be consistent across all of our survey questions.
For agencies that reported conducting overservice enforcement efforts, we asked a series of follow-up questions: How often has your agency conducted each of the following efforts to target illegal sales to obviously intoxicated patrons at licensed alcohol establishments: (1) random inspections; (2) walk-throughs within licensed establishments; (3) observations for overservice of alcohol; (4) BAC testing; (5) pseudo-intoxicated or pseudo-drunk purchase attempts; and (6) “last call” enforcement (response options for each of the six actions were: no; yes, once a year; yes, a few times a year; yes, monthly; or yes, weekly). For these six measures, we include descriptive statistics only.
Because there are few studies on overservice practices to guide our selection of independent variables, we chose agency and jurisdiction characteristics that we hypothesized may affect the likelihood of conducting overservice enforcement efforts based on previous studies of alcohol enforcement practices (e.g. 19–21]. We created two independent measures based on survey items that were common in both the local and state agency surveys. Number of officers or agents per population was measured based on responses to: “How many full-time enforcement agents/officers does your agency employ?”; we expressed this as a ratio—number of agents per 1000 population for local agencies and per 1,000,000 population for state agencies (population measures obtained from U.S. Census). This ratio measure was highly skewed so we created three-level categorical variables: <2, 2–4, ≥4 for local and <6, ≥6 for state). The second common independent measure was based on “How common is the overservice of alcohol at alcohol establishments in your jurisdiction?” (response options: not common, somewhat common, very common, recoded to “not common” vs. “somewhat/very common”). Recoding of both variables was based on frequency distributions.
From the local agency survey, we included one additional independent measure pertaining to whether the agency had any full-time officers assigned primarily to enforcement of alcohol-related laws (yes/no). From the state agency survey, we included three additional independent measures pertaining to: (1) the agency primarily responsible for enforcing alcohol retail laws and regulation in the jurisdiction (response options: state agency, local agencies, or both); (2) the number of on-premise alcohol establishments in the agency’s jurisdiction (e.g., bars, restaurants, clubs); and (3) the number of off-premise alcohol establishments in the agency’s jurisdiction (e.g., liquor stores, grocery stores). The last two measures had open-ended responses that had considerably skewed distributions so we dichotomized these for analyses as <5000, ≥5000 for on-premise and <3000, ≥3000 for off-premise (approximate median split).
Finally, we obtained demographic characteristics for jurisdictions of the local and state agencies from the 2010 U.S. Census. These included total population of jurisdiction (used for creating the number of officers per population), percent living in poverty, percent Black, and percent Hispanic. For analyses, because many of the demographic measures had considerably skewed distributions with outliers, we recoded these as either dichotomous (based on median split), or three- or four-level variables depending on the frequency distributions and ease of interpretation (see Tables 2 & 3). We also included a measure that categorizes states into three regions based on alcohol consumption patterns, as defined by Kerr [22]: dry, moderate, or wet (Table 1).
Table 2.
Bivariate and multivariate models for conducting overservice enforcement efforts: Local agencies (n=959)
| Bivariate analyses | Multivariate model |
||
|---|---|---|---|
| Independent variables | Percent of agencies 1 |
Χ2 (p) | Odds ratio (95% CI) |
| Population of jurisdiction | |||
| < 10K | 22% | 13.35 (.004)* |
0.64 (0.28, 1.42) |
| 10K–50K | 23% | 0.63 (0.29, 1.36) | |
| 50K–250K | 32% | 0.85 (0.37, 1.93) | |
| > 250K | 42% | Ref. | |
| Percent black | |||
| < 1% | 27% | 10.27 (.016)* |
1.74 (0.75, 4.05) |
| 1–10% | 26% | 1.63 (0.72, 3.68) | |
| 10–25% | 23% | 1.38 (0.57, 3.32) | |
| > 25% | 12% | Ref. | |
| Percent Hispanic | |||
| < 3% | 18% | 17.51 (.0006)* |
0.52 (0.24, 1.10) |
| 3–10% | 27% | 0.74 (0.37, 1.49) | |
| 10–25% | 30% | 0.83 (0.41, 1.68) | |
| > 25% | 36% | Ref. | |
| Percent poverty | |||
| < 15% | 26% | 6.13 (.047)* | 1.31 (0.69, 2.50) |
| 15–25% | 26% | 1.25 (0.66, 2.38) | |
| > 25% | 15% | Ref. | |
| Region (by state) | |||
| Dry (South) | 21% | 2.05 (.358) | -- |
| Moderate (Mid-Atlantic,Pacific, South Coast) | 26% | ||
| Wet (North Central/New England) | 25% | ||
|
Number of fulltime officers per 1000 population |
|||
| < 2 | 26% | 2.90 (.235) | -- |
| 2–4 | 23% | ||
| ≥ 4 | 18% | ||
|
Full-time officer(s) assigned to alcohol enforcement |
|||
| No | 20% | 26.05 (<.0001)* |
0.39 (0.27, 0.56)* |
| Yes | 36% | Ref. | |
|
How common is over-service in jurisdiction? |
|||
| Not common | 19% | 12.04 (.0005)* |
0.60 (0.42, 0.85)* |
| Somewhat/very common | 29% | Ref. | |
percentages reported are the percent of agencies doing overservice enforcement at each level of the independent variable.
significant at p < .05
Ref. = referent group
Table 3.
Bivariate models for conducting overservice enforcement efforts: State agencies (n=44)
| Bivariate analyses | Multivariate model |
||
|---|---|---|---|
| Independent variables | Percent of agencies1 |
Χ2 (p) | Odds ratio (95% CI) |
| Population of jurisdiction | |||
| < 5 million | 48% | 4.36 (.037)* |
1.06 (0.06, 19.01) |
| ≥ 5 million | 79% | Ref. | |
| Percent black | |||
| < 7% | 64% | 0.096 (.757) |
-- |
| ≥ 7% | 59% | ||
| Percent Hispanic | |||
| < 7% | 57% | 0.302 (.583) |
-- |
| ≥ 7% | 65% | ||
| Percent poverty | |||
| < 13% | 64% | 0.096 (.757) |
-- |
| ≥ 13% | 59% | ||
| Region | |||
| Dry (South) | 55% | 2.58 (.276) | -- |
| Moderate (Mid-Atlantic, Pacific, South Coast) |
79% | ||
| Wet (North Central/New England) |
53% | ||
|
Number of fulltime agents per 1,000,000 population |
|||
| < 6 | 56% | 0.703 (.402) |
-- |
| ≥ 6 | 68% | ||
|
How common is overservice in jurisdiction? |
|||
| Not common | 75% | 0.114 (.736) |
-- |
| Somewhat/very common | 67% | ||
|
Who is primarily responsible for enforcement of alcohol retail laws? |
|||
| State | 65% | 6.03 (.049)* |
0.54 (0.11, 2.62) |
| Local | 17% | 0.07 (0.04, 1.02) |
|
| Both | 71% | Ref. | |
|
Number of on-premise establishments |
|||
| < 5000 | 48% | 5.08 (.024)* |
0.18 (0.10, 3.03) |
| ≥ 5000 | 81% | Ref. | |
|
Number of off-premise establishments |
|||
| < 3000 | 60% | 0.107 (.744) |
-- |
| ≥ 3000 | 65% | ||
percentages reported are the percent of agencies doing overservice enforcement at each level of the independent variable
Ref. = referent group
significant at p < .05
Table 1.
Descriptive statistics: Local and state jurisdictions/agencies
| Local agencies (n=1082) |
State agencies (n=49) | |
|---|---|---|
|
Jurisdiction/Agency Characteristics |
Mean (SD; range) | Mean (SD; range) |
| Population | 72,245 (331,140; 10–8.2 mil.) | 6.3 mil (6.9 mil.; 0.56mil.–37mil.) |
| Percent black | 8.8% (16%; 0%–88%) | 10% (9.5%; 0.38%–37%) |
| Percent Hispanic | 9.3% (14%; 0%–97%) | 11% (10%; 1.2%–46%) |
| Percent poverty | 15% (8.9%; 0%–50%) | 13% (2.9%; 7.8%–21%) |
| On-premise establishments | -- | 8227 (10,014; 795–47,000) |
| Off-premise establishments | -- | 6623 (10,663; 250–60,000) |
| Fulltime officers/agents per population1 | 3.3 (22; 0–700) | 7.2 (6.7; 0–28) |
| Percent of agencies2 | Percent of agencies | |
|
Full-time officer(s) assigned to alcohol enforcement |
||
| Yes | 26% | -- |
| No | 74% | -- |
|
Agency primarily responsible for enforcing alcohol retail laws |
||
| State | -- | 39% |
| Local | -- | 14% |
| Both | -- | 47% |
| Region | ||
| Dry (South) | 26% | 24% |
| Moderate (Mid-Atlantic, | 34% | 35% |
| Pacific, South Coast) | ||
| Wet (North Central/New England) | 40% | 41% |
|
How common is overservice in jurisdiction |
||
| Not common | 45% | 10% |
| Somewhat/very common | 55% | 90% |
|
Conduct enforcement efforts for overservice |
||
| Yes | 19% | 55% |
| No | 72% | 35% |
| Do not have authority | 6% | 8% |
| Don’t know | 3% | 2% |
| Among those that have authority | 20% | 60% |
| [If yes] Types of efforts used: | ||
| Random inspections | ||
| No | 20% | 4% |
| Yes, yearly or a few times/year | 53% | 54% |
| Yes, weekly or monthly | 27% | 42% |
| Walk-throughs | ||
| No | 5% | 12% |
| Yes, yearly or a few times/year | 48% | 44% |
| Yes, weekly or monthly | 48% | 44% |
| Observations for overservice |
||
| No | 26% | 15% |
| Yes, yearly or a few times/year | 47% | 42% |
| Yes, weekly or monthly | 27% | 42% |
| BAC testing | ||
| No | 67% | 87% |
| Yes, yearly or a few times/year | 14% | 9% |
| Yes, weekly or monthly | 19% | 4% |
| Pseudo-intoxicated purchase attempts |
||
| No | 91% | 100% |
| Yes, yearly or a few times/year | 7% | 0 |
| Yes, weekly or monthly | 2% | 0 |
| “Last call” enforcement | ||
| No | 50% | 61% |
| Yes, yearly or a few times/year | 29% | 9% |
| Yes, weekly or monthly | 20% | 30% |
For local agencies, number of officers per 1000 persons; for state agencies, number of agents per 1,000,000 persons
Percentages from survey measures are weighted to account for sampling and non-response
Note: Some data are missing (--) due to that item not included on survey (state and local survey instruments varied).
Analyses
We conducted three phases of analyses. First, we calculated descriptive statistics for all measures, using survey weights to account for our sampling plan and survey non-response for all local agency survey measures. Second, we conducted bivariate (Chi-square) and multivariate analyses between our outcome measure and each independent measure; our outcome measure was a dichotomous indicator of whether the agency conducted overservice enforcement. All independent measures that were statistically significant (p < .05) in bivariate analyses were included in multivariate logistic regression models (separate models for local and state agencies; for the local agency model we included state as a random effect). Third, we combined local and state data, assigning local agencies to their state-level agency. We calculated the proportion of local agencies in each state that conducted overservice enforcement creating a dichotomous indicator via median split (<21%; ≥21%). We measured the association between this indicator and the dichotomous indicator of whether the state agency conducted overservice enforcement using cross-tabulation.
Results
Descriptive statistics are displayed in Table 1. Fifty-five percent of local agencies and 90% of state agencies reported that sales to obviously intoxicated patrons were somewhat or very common in their jurisdiction. Among the 1017 local agencies and 44 state agencies that reported having the authority to conduct overservice enforcement efforts, 20% of local and 60% of state agencies had conducted such efforts in the past year. Among local and state agencies conducting overservice enforcement, over 80% conducted random inspections, over 90% conducted walk-throughs, and over 70% conducted observations for overservice in the last year. BAC testing, pseudo-intoxicated purchase attempts and last call enforcement were less commonly reported. Among local agencies, 26% had a full-time officer assigned primarily to enforcement of alcohol-related laws. Among state agencies, 47% reported that both state and local agencies were responsible for enforcement of alcohol retail laws.
Overservice enforcement efforts by local law enforcement agencies differed by the characteristics of the jurisdiction of those agencies. Bivariate analyses showed that among local agencies (Table 2), those agencies in smaller jurisdictions, those with a higher proportion of black residents, those with lower proportion of Hispanic residents, and those having a greater proportion living in poverty were all less likely to conduct overservice enforcement efforts. Local agencies that had a full-time officer assigned to alcohol enforcement (vs. those without a full-time alcohol enforcement officer) were more likely to conduct enforcement efforts to address sales to obviously intoxicated patrons. Local agencies that reported sales to obviously intoxicated patrons were somewhat or very common in their jurisdiction (vs. not common) were more likely to conduct enforcement efforts to address these sales. In multivariate models for local agencies (Table 2), two measures remained statistically significant. Agencies that had a full-time officer assigned to alcohol enforcement (vs. agencies without a fulltime alcohol officer) had 2.5 greater odds of conducting overservice enforcement efforts. Agencies where overservice was reported to be somewhat/very common (vs. not common) had 1.7 greater odds of conducting overservice enforcement efforts.
Bivariate analyses for state agencies (Table 3) showed that three of the independent measures were significantly associated with our outcome—agencies in jurisdictions with larger populations, those with more on-premise establishments, and those where either the state agency alone or the state agency along with the local agency is/are primarily responsible for enforcement of alcohol retail laws (vs. jurisdictions where only the local agency is responsible) were more likely to conduct overservice enforcement efforts. In the multivariate model, none of these measures remained statistically significant.
Looking at overall overservice enforcement efforts in each state via the combined data from state and local agencies, we found that in 35% of states enforcement efforts are conducted by the state agency and at least 21% (median) of local agencies, but in 29% of states enforcement efforts are not conducted by the state agency and are conducted by a less than 21% of local agencies (see Table 4 for full results).
Table 4.
Relationship between local- and state-level overservice enforcement by state (n=49)
| State-level enforcement | ||
|---|---|---|
| Yes | No | |
| Local-level enforcement1 | Percent (number) of states |
|
| Below median | 20% (10) | 29% (14) |
| At or above median | 35% (17) | 16% (8) |
median = 21% (median percentage of local agencies conducting overservice enforcement across 49 states)
Discussion
Violations of laws that prohibit overservice of alcohol are common in the U.S. according to law enforcement agencies; however, very few local law enforcement agencies actively enforce these laws. We found that only about one in five local law enforcement agencies reported conducting enforcement efforts to address sales to obviously intoxicated patrons in the past year. A larger proportion of state agencies take steps to actively enforce overservice laws—over half reported active enforcement efforts in the past year. Given that sales to obviously intoxicated patrons are common in many of these jurisdictions and that several studies have shown a high likelihood of sales to obviously intoxicated patrons at alcohol establishments [3–4, 6–7] there appears to be considerable room for improvement in addressing this type of illegal alcohol sale. Reducing sales to obviously intoxicated persons is an important public health issue because these sales can lead to excessive consumption and problems such as motor vehicle crashes, assaults, and other violent crime.
The main characteristic of local agencies associated with a higher likelihood of conducting overservice enforcement efforts was having a full-time officer specifically assigned to carry out alcohol enforcement efforts. Our results suggest that all types of agencies regardless of the characteristics of their jurisdictions could improve their efforts to address sales to obviously intoxicated patrons in licensed establishments. It is possible that other jurisdiction and agency characteristics not included in these analyses may differentiate agencies’ overservice enforcement efforts (e.g., alcohol policy environment). Local agencies with adequate resources to do so may want to consider assigning an officer to address alcohol issues. Despite likely limited resources among many agencies, having an officer assigned specifically to alcohol issues may be financially prudent given that many types of crime, both serious and less serious, are associated with alcohol use [11–14].
At the state level, a few of the jurisdiction characteristics—larger population, more on-premise establishments, and having the state agency (or state plus local agency) primarily responsible for alcohol retail enforcement—were associated with a greater propensity to conduct overservice enforcement (Table 3); none remained statistically significant in multivariate analyses likely due to low power (n=44). In general, smaller states and those with fewer on-premise establishments may need to particularly increase efforts at the state-level to address overservice. In addition, it is possible that more comprehensive enforcement is conducted in states where both the state and local law enforcement agencies are active in enforcing alcohol retail laws. When considering the state and local agency data together, we found that in only 17 states, both the state agency and at least 21% (overall median) of the local agencies conducted overservice enforcement efforts. Increased coordination between local and state agencies to address sales to obviously intoxicated patrons may be needed.
Among agencies conducting enforcement efforts to address sales to obviously intoxicated patrons, we assessed what specific types of enforcement strategies were employed. The most common strategies were random inspections, walk-throughs, and observations for overservice at alcohol establishments; however, less than half used any these specific strategies on at least a monthly basis in the past year. Although there is not adequate research available to recommend specific types of enforcement strategies to use to address overservice of alcohol, agencies can perhaps increase the frequency of using some type of strategy to address this problem. Effects of enforcement can decay rapidly and frequent efforts may lessen this decay [23–24]. One potential explanation for the lack of use of these strategies, as well as other types of overservice enforcement, is that although they may have some deterrent effect, officers may be hesitant to employ such efforts because it can be difficult to obtain sufficient legal evidence to prove that an obviously intoxicated patron was actually served [15]. Limited resources are also a likely factor, and the more general strategies such as random inspections and walk-throughs may have limited effectiveness in leading to citations specifically for overservice given that the agents may be looking for various types of violations (not only overservice) during the establishment visit.
Several limitations should be considered when interpreting these data. First, most of our data were based on self-report from enforcement agencies. Respondents may have over- or under-reported agency efforts; however, we asked to survey the agency representative most knowledgeable about alcohol enforcement efforts within the agency in an attempt to reduce this potential bias. Second, although we attempted to survey a representative sample of local agencies within each state, some bias may have been introduced due to non-response (particularly among smaller agencies), and do to our complex sampling scheme, despite employing weighted analyses. Also, for the few states (e.g., Maryland, Nevada) where state agencies have a limited alcohol enforcement role, we may not have captured the full picture of enforcement. Third, this study assessed what actions enforcement agencies are taking to address alcohol sales to obviously intoxicated patrons, but it did not assess the effectiveness of these enforcement actions; agencies may also be using other strategies that were not included in the survey (e.g., targeting problem establishments). Studies are needed to identify the most cost effective interventions to prevent these high-risk alcohol sales. Fourth, we did not ask respondents whether their jurisdiction had a specific law prohibiting sales to intoxicated patrons. For the two states (Florida and Nevada) that did not have a state law specifically prohibiting sales to intoxicated persons [15], responses from the local agency survey participants who indicated their agency conducts overservice enforcement (one in each Florida and Nevada) may be inaccurate or may represent enforcement of a law that is different than laws in other states. We also did not assess respondents’ perceptions regarding the likelihood of overservice violations leading to prosecution. Finally, due to the cross-sectional design of the study, we are not able to make causal inferences.
Despite some limitations, our study provides one of the first assessments of whether enforcement agencies in the U.S. are addressing overservice of alcohol and what type of enforcement activities the agencies are using to address this problem. We found that most local agencies and about one in three of state agencies do not conduct overservice enforcement efforts. These results suggest that an increased focus on reducing sales to obviously intoxicated patrons may be a useful strategy for reducing excessive alcohol consumption and the social and health harms that result from excessive consumption, particularly among local law enforcement agencies. Research studies that help to identify the most effective types of enforcement efforts may help increase attention to this issue.
Acknowledgments
This study was supported by a grant from the National Institute of Alcohol Abuse and Alcoholism (R01 AA017873; Darin J. Erickson, Principal Investigator)
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