Abstract
Excessive alcohol consumption can result from illegal sales to intoxicated patrons at bars and restaurants. We surveyed bar/restaurant managers about their practices in reducing illegal sales to intoxicated patrons. We found that managers were confident that they could refuse service to intoxicated customers but were less likely to have communicated necessary information to their staff on how to refuse such sales. Managers who agreed that a business in their community would be cited for overservice were more likely to be confident that they could handle customers who had been cut off from alcohol service. Our study suggests that bar/restaurant managers may need training to improve their communication with staff and that increased enforcement may lead to an increase in manager confidence in handling intoxicated patrons.
INTRODUCTION
Excessive alcohol use is associated with negative health consequences, including traffic crashes, personal injuries and violence (National Highway Traffic Safety Administration, 2013; Savola, Niemela, & Hillbom, 2005). Excessive consumption can result from overservice of alcohol (e.g., serving alcohol to patrons who are obviously intoxicated) at licensed establishments, such as bars and restaurants, and is directly related to these outcomes (Graham, Osgood, Wells, & Stockwell, 2006; Stockwell, Lydon, & Rydon, 1993). Evidence suggests greater risk of harms as intoxication levels increase (Graham et al., 2006). Establishments serving alcohol often facilitate over-consumption by encouraging excessive drinking through drink specials and promotions (Thombs et al., 2008), and servers in licensed establishments commonly provide alcohol to patrons who exhibit obvious signs of intoxication, despite laws prohibiting this practice (Buvik, 2013; Freisthler, Gruenewald, Treno, & Lee, 2003; Gosselt, Van Hoof, Goverde, & De Jong, 2013; Lenk, Toomey, & Erickson, 2006).
Altering the physical and social environment within alcohol serving establishments can help reduce the harms associated with excessive consumption. Effective approaches include changing establishment practices that promote heavy alcohol use (Babor et al., 2010). Establishment policies may be influenced through Responsible Beverage Service (RBS) training that focuses on manager and policy development (Toomey et al., 2001, 2008). Measuring all drinks (no “free pouring”), promoting food and non-alcoholic beverages, and refusing alcohol service to customers who appear intoxicated are all examples of establishment policies that may help reduce the likelihood of overservice and over-consumption (Saltz, 1989; Toomey, Erickson, Lenk et al., 2008).
General managers of licensed alcohol establishments are the persons responsible for development, implementation and enforcement of policies within establishments (Saltz, 1989; Toomey et al., 2001; 2008). To help servers maintain responsible beverage service practices, management can develop, promote and enforce the establishment policies (Toomey et al., 2008). No studies that we identified have evaluated characteristics of the general managers, and the establishments they manage, to determine their influence on responsible beverage service practices pertaining to reducing sales to obviously intoxicated patrons.
In the present exploratory study, we assessed whether specific characteristics of general managers and their establishments were associated with establishment responsible beverage service practices for reducing sales to obviously intoxicated patrons. As part of baseline data collection of a larger trial to implement and evaluate a management training program, we surveyed the general manager of each participating establishment regarding their practices and confidence related to promoting responsible alcohol service. Results may inform the design and implementation of establishment-specific training and in-house enforcement interventions focusing on general managers of alcohol establishments to promote responsible beverage service.
METHODS
As part of a larger trial, enhanced Alcohol Risk Management (eARM™ Program), we developed a training program for general managers to be implemented in bars and restaurants. The Institutional Review Board at the University of Minnesota approved this study. Data collection for the larger trial included a baseline survey of general managers of bars and restaurants in one large Midwestern metropolitan area between October 2011 and March 2014.
Sample
We obtained a list of on-premise alcohol establishments from the State Department of Public Safety. Research staff mailed a postcard that introduced the study to bars and restaurants in 15 communities (n = 1,132). Staff made follow-up telephone calls to each establishment asking to speak with the general manager. The general manager could be the establishment owner or a manager designated as the decision maker for the establishment. At the time of the recruitment telephone calls, 11.3% of the establishments were no longer in business and 12.7% were excluded from the study for a variety of reasons (safety concerns, language barriers, private clubs, etc.). At other establishments, research staff were simply unable to contact a general manager. Of the establishments we attempted to recruit by telephone, 340 (40% recruitment rate) agreed to participate in eARM. Staff recorded the name of the person from each establishment who agreed to participate in the study; these general managers were later contacted to complete a survey before the intervention began.
Survey
The survey contained 24 items that assessed establishment and general manager characteristics and management practices regarding responsible alcohol service. Trained research staff, following a standardized protocol, attempted to conduct a telephone survey with the general manager of each establishment. Each establishment was contacted up to twenty times to attempt to complete the survey. If staff were unable to complete the survey by telephone, the eARM trainer asked the general manager to complete a hard copy of the survey at the beginning of the training program. Surveys were completed at 336 of the 340 establishments (response rate for our sample = 99%), with 142 conducted over the phone and 194 in person. Respondents self-identified as managers (n=136), owners (n=118), and assistant managers or “others” (n=82). All completed surveys were double keyed into a Microsoft Access database system.
Variables
A total of 16 variables were used for this study, nine independent and seven dependent. We constructed 14 variables from survey items and two from other sources.
Independent Variables
Nine independent variables were used to assess establishment and general manager characteristics. Establishment characteristics included the number of managers at the establishment (1, 2–3, 4–6, 6+; collapsed for analyses to <4, 4+) and the turnover rate among establishment service staff within the past year (≤10%, 11–25%, 26–50%, 51–75%, 76–100%; collapsed for analyses to ≤25%, >25%). At the time of recruitment, we asked how many servers were on staff at the establishment; based on this information we created a variable of serving staff size (0–9, 10–19, 20+). Additionally, we created a variable that indicated the type of ownership of the establishment (independent, corporate). Independent establishments were owned by individuals or families and an establishment was categorized as corporate if it was part of a chain or holding group.
The five general manager characteristics were: (1) position within the establishment (owner, assistant manager, general manager, other; collapsed to owner, manager, assistant/other), (2) years in their position (≤3 months, more than 3 but less than 6 months, more than 6 months but less than 1 year, between 1 and 5 years, over 5 years; collapsed to less <1, 1–5, 5+), (3) total years in the industry (≤1 year, 1–5 years, 6–10 years, >10 years; collapsed to ≤10, 10+), (4) age (21–25, 26–30, 31–35, 36–40, 41–45, 46–50, over 50; collapsed to ≤35, >35), and (5) perception of whether an establishment within their community would be cited for serving an obviously intoxicated customer (strongly disagree, somewhat disagree, somewhat agree, strongly agree; collapsed to strongly agree vs. other).
Dependent Variables
We examined seven dependent variables from the survey, three assessed specific management practices: (1) whether the establishment had written policies regarding responsible beverage service (yes, no); (2) when written policies were distributed to staff (before first shift, within a month of hire, at periodic staff meetings, as needed; collapsed for analyses to before first shift vs. other); and (3) how often staff meetings were conducted to discuss responsible beverage service (daily, at least once per week, a couple times per month, once per month, a few times a year, never; collapsed for analyses to at least monthly vs. less frequently).
The other items assessed general managers’ confidence and beliefs by asking how strongly they agreed with the following statements: (1) I am confident that I can get other managers in my establishment to consistently enforce our alcohol policies; (2) I am confident that I can effectively deal with an angry customer who has been cut off from alcohol service; (3) I will always support my servers’ decisions to cut off an intoxicated customer; and (4) management has developed and communicated the steps staff should take when they cut off an intoxicated customer from alcohol service. Response options for all four confidence and belief variables were on a four-point Likert Scale, with possible answers of strongly disagree, somewhat disagree, somewhat agree and strongly agree; we dichotomized the responses for analyses to strongly agree vs. other.
Collapsing of survey responses for the dependent and independent variables was based primarily on the frequency distribution of responses (e.g., the majority of responses were in one or two categories with few responses in other categories). In some cases, we also took into consideration recommended practices (e.g., holding staff meetings at least monthly) and practical expertise in the field (e.g., number of servers; Dixon et al., 2016).
Analysis
We conducted three phases of analyses. First, descriptive statistics were calculated for each of the variables. Next we conducted bivariate analyses (Chi-square) to assess which of the nine independent variables were associated with each dependent variable. Finally we estimated multilevel multivariate logistic regression models for each of the dependent variables that had more than one independent variable that was statistically significant at p<0.05 in bivariate analyses. We estimated multivariate models that included community as a random effect to control for the potentially biasing effect of nesting of establishments within communities (i.e., establishments in the same communities might be more similar than establishments in different communities; Murray, 1998). We computed correlations between all independent variables to assess possible multicollinearity and found none. All analyses were conducted using SAS version 9.3.
RESULTS
Descriptive statistics are presented in Table 1. The majority of respondents had at least one year of experience in their current position at their establishment (80%) and over 10 years of experience in the service industry (77%). More than half (65%) strongly agreed that a business in their community would be cited for serving an obviously intoxicated customer. Less than a quarter (17%) of the establishments were part of a corporation.
Table 1.
Descriptive Statistics
| INDEPENDENT VARIABLES | % (N) |
|---|---|
| Participant Characteristics | |
| Position of participant completing survey | |
| Owners | 35 (118) |
| Managers | 41 (136) |
| Assistant managers and others | 24 (82) |
| General Managers’ age | |
| Under age 35 | 35 (118) |
| Age 35 or older | 65 (217) |
| Years in position | |
| < 1 year | 20 (68) |
| 1–5 years | 41 (139) |
| 5+ years | 38 (128) |
| Years in industry | |
| ≤ 10 years | 23 (76) |
| > 10 years | 77 (259) |
| Agreement that an establishment will be cited for overservice | |
| Strongly agree | 65 (216) |
| Other | 35 (115) |
| Establishment Characteristics | |
| Type | |
| Corporate | 17 (58) |
| Independent | 83 (277) |
| Staff turnover rate | |
| ≤ 25% | 72 (239) |
| >25% | 28 (94) |
| Number of managers | |
| < 4 | 65 (220) |
| ≥ 4 | 35 (116) |
| Number of servers | |
| 0 – 9 | 32 (108) |
| 10 – 19 | 29 (96) |
| ≥ 20 | 39 (131) |
|
| |
| DEPENDENT VARIALBES | |
|
| |
| General Manager Confidence and Beliefs | % (N) Strongly Agree |
| Always support servers decisions to cut off intoxicated customers | 87 (293) |
| Can get other managers to consistently enforce policies | 84 (280) |
| Can handle an angry customer who has been cut off | 75 (251) |
| Management developed/communicated steps to cut off intoxicated customers | 40 (133) |
| Procedures | % (N) |
| Have written policies | 64 (214) |
| Hand out written policies before 1st shift | 47 (158) |
| Hold staff meeting at least monthly | 36 (119) |
The majority of general managers strongly agreed that they always support their servers’ decisions to cut off intoxicated customers (87%) and that they can get other managers to consistently enforce establishment alcohol policies (84%). Over half (64%) of the establishments had written policies. Less than half (47%) of the establishments distributed written policies to staff before their first shift. Less than half (40%) of the general managers strongly agreed that management has developed and communicated the steps staff should take when cutting off alcohol service to an intoxicated customer.
Bivariate Analyses
All but one of our independent variables were significantly associated (p<0.05) with at least one of our seven dependent variables. The age of the general manager was the only independent variable that did not have a statistically significant association with a dependent variable (Tables 2 and 3).
Table 2.
Bivariate Results – Management Practices
| DEPENDENT VARIABLES | |||
|---|---|---|---|
|
| |||
| INDEPENDENT VARIABLES | Have written policies | Hand out policies before first shift | Hold staff meeting at least monthly |
| Participant Characteristics | Percent of establishments (at each level of independent variable) | ||
|
| |||
| Position | |||
| Owner | 47* | 6* | 33 |
| Manager | 76 | 23 | 36 |
| Assistant/Other | 67 | 13 | 39 |
| Age | |||
| Under age 35 | 66 | 14 | 41 |
| Age 35 or older | 63 | 15 | 33 |
| Years in position | |||
| <1 | 69 | 18 | 41 |
| 1–5 | 67 | 17 | 35 |
| >5 | 57 | 11 | 33 |
| Years in industry | |||
| ≤10 | 63 | 9 | 47* |
| 10+ | 64 | 16 | 33 |
| Establishment will be cited for overservice | |||
| Strongly agree | 61 | 11 | 34 |
| Other | 66 | 16 | 36 |
|
| |||
| Establishment Characteristics | Percent of establishments (at each level of independent variable) | ||
|
| |||
| Type | |||
| Independent | 59* | 12* | 34 |
| Corporate | 84 | 26 | 41 |
| Staff turnover | |||
| ≤25% | 61* | 12* | 36 |
| >25% | 73 | 21 | 34 |
| Number of managers | |||
| <4 | 54* | 9* | 34 |
| 4+ | 83 | 26 | 39 |
| Number of servers | |||
| 0–9 | 44* | 8* | 39 |
| 10–19 | 63 | 10 | 34 |
| 20+ | 80 | 23 | 34 |
Significant at p < .05 (chi square)
Table 3.
Bivariate Results – Manager Confidence and Beliefs
| DEPENDENT VARIABLES | ||||
|---|---|---|---|---|
|
| ||||
| INDEPENDENT VARIABLES | Support servers’ decisions to cut off intoxicated | Get other managers to consistently enforce policies | Can deal with an angry customer who has been cut off | Developed and communicated steps to cut off intoxicated |
| General Manager Characteristics | Percent of managers who strongly agree (at each level of independent variable) | |||
|
| ||||
| Position | ||||
| Owner | 92 | 91 | 77 | 47* |
| Manager | 85 | 87 | 76 | 40 |
| Assistant/Other | 85 | 86 | 70 | 28 |
| Age | ||||
| Under age 35 | 84 | 87 | 74 | 34 |
| Age 35 + | 89 | 89 | 76 | 43 |
| Years in position | ||||
| <1 | 82 | 86 | 79 | 32* |
| 1–5 | 86 | 86 | 74 | 35 |
| >5 | 91 | 92 | 74 | 48 |
| Years in industry | ||||
| ≤10 | 83 | 89 | 66* | 36 |
| 10+ | 89 | 88 | 78 | 41 |
| Establishment will be cited for overservice | ||||
| Strongly agree | 92* | 94* | 81* | 49* |
| Other | 80 | 77 | 64 | 23 |
|
| ||||
| Establishment Characteristics | Percent of managers who strongly agree (at each level of independent variable) | |||
|
| ||||
| Type | ||||
| Independent | 87 | 89 | 73* | 39 |
| Corporate | 91 | 82 | 86 | 45 |
| Staff turnover | ||||
| ≤25% | 89 | 87 | 72* | 44* |
| >25% | 85 | 91 | 83 | 30 |
| Number of managers | ||||
| <4 | 88 | 89 | 74 | 40 |
| 4+ | 87 | 86 | 78 | 40 |
| Number of servers | ||||
| 0–9 | 90 | 90 | 73 | 37 |
| 10–19 | 88 | 91 | 75 | 38 |
| 20+ | 85 | 85 | 76 | 44 |
Significant at p < .05 (chi square)
Bivariate analyses of management practices indicated that establishments where a respondent was a manager (vs. owner or “other”), establishments that had at least four managers, establishments that were part of a corporation (vs. independent), those with more staff turnover, and those with more servers were all more likely to have written policies and distribute those policies to staff before their first shift. Respondents who had been in the industry less than 10 years (vs. 10+ years) were more likely to conduct staff meetings at least monthly.
Bivariate analyses of general managers’ confidence and beliefs indicated that respondents who had been in the industry for a longer time, those who strongly agreed (vs. less agreement) that an establishment would be cited for over-service, those who were part of a corporate (vs. independent) establishment, and those that had more staff turnover all were more likely to strongly agree that they could handle an angry customer who had been cut off from service. Respondents who were establishment owners (vs. manager or other), those who had been in their current position longer, those who strongly agreed that an establishment would be cited for over-service, and respondents from establishments with a lower staff turnover rate all were more likely to strongly agree that management had developed and communicated the steps staff should take when they cut off an intoxicated customer from service.
Only one independent variable, agreement that an establishment would be cited for overservice, was associated with the other two dependent variables—managers who strongly agreed that they always support servers’ decisions to cut off intoxicated customers and those who strongly agreed that they can get other managers to consistently enforce policies were both more likely to agree that an establishment would be cited for overservice.
Multivariate Analyses
We conducted multivariate analyses for four dependent variables—establishment has written policies, policies are handed out before first shift, general managers are confident in dealing with an angry customer who has been cut off, and management has developed and communicated how to cut off an intoxicated customer (Table 4). Establishments where a manager (vs. owner or “other”) completed the survey and larger establishments (20+ servers, 4+ managers) were at least twice as likely to have written policies. Establishments with four or more managers were nearly three times as likely to hand out the written policies before their servers’ first shift (vs. at some other time).
Table 4.
Multivariate Results: One Model for Each Dependent Variable1
| DEPENDENT VARIABLES | ||||
|---|---|---|---|---|
|
| ||||
| INDEPENDENT VARIABLES | Have written policies | Hand out policies before first shift | Strongly agree: Confident in handling angry customer who was cut off | Strongly agree: Communicated to staff how to cut off intoxicated |
| Participant Characteristics | Odds ratio (95% CI) | |||
|
| ||||
| Position | ||||
| Owner | referent | – | – | referent |
| Manager | 2.0 (1.1, 3.7)* | – | – | 1.0 (0.6, 1.8) |
| Assistant/Other | 1.3 (0.7, 2.5) | – | – | 0.6 (0.3, 1.1) |
| Years in position | ||||
| <1 | – | – | – | referent |
| 1–5 | – | – | – | 0.9 (0.5, 1.8) |
| >5 | – | – | – | 1.4 (0.7, 2.9) |
| Years in industry | ||||
| ≤10 | – | – | referent | – |
| 10+ | – | – | 1.8 (1.0, 3.3)* | – |
| Establishment will be cited for overservice | ||||
| Strongly agree | – | – | 2.3 (1.3, 3.8)* | 3.5 (2.0, 5.9)* |
| Other | – | – | referent | referent |
|
| ||||
| Establishment Characteristics | Odds ratio (95% CI) | |||
|
| ||||
| Type | ||||
| Independent | referent | referent | referent | – |
| Corporate | 1.8 (0.8, 4.1) | 1.4 (0.6, 3.0) | 2.0 (0.9, 4.6) | – |
| Staff turnover | ||||
| ≤25% | referent | referent | referent | referent |
| >25% | 1.7 (1.0, 3.0) | 2.0 (1.0, 3.9) | 1.7 (0.9, 3.3) | 0.5 (0.3, 0.9)* |
| Number of managers | ||||
| <4 | referent | referent | – | – |
| 4+ | 2.3 (1.2, 4.4)* | 2.7 (1.3, 5.7)* | – | – |
| Number of servers | ||||
| 0–9 | referent | referent | – | – |
| 10–19 | 1.7 (1.0, 3.2) | 1.0 (0.4, 2.8) | – | – |
| 20+ | 2.5 (1.3, 4.9)* | 1.8 (0.7, 4.5) | – | – |
Significant at p < .05
Mixed model regression
– Not included in model
Respondents who had 10 or more years in the industry (vs. <10) and those who strongly agreed that a business would be cited for over-service were about twice as likely to strongly agree that they could handle an angry customer who had been cut off from alcohol service. Respondents who strongly agreed that a business would be cited for over-service were 3.5 times as likely to strongly agree that they had communicated the steps to staff on how to cut off intoxicated patrons from alcohol service. Respondents who managed establishments with high staff turnover rates (>25%) were half as likely to strongly agree that they had communicated the steps to staff on how to cut off intoxicated patrons from alcohol service.
DISCUSSION
This study provides the first assessment of bar/restaurant general manager and establishment characteristics and their relationship with establishment practices regarding responsible alcohol service. We found that most general managers are confident that they can get other managers to enforce establishment policies and that they can refuse service to intoxicated customers. General managers also believe that they always support their servers decisions. However, it appears that most general managers have not communicated the steps to their staff on how to refuse sales to intoxicated customers.
One recommended method for promoting responsible alcohol service in alcohol establishments is for general managers to adopt and implement written policies (Toomey et al., 2008; Room, Babor & Rehm, 2005). With just over half of the establishments having written policies, there is room for improvement. In general, implementation of alcohol policies includes communicating the policies, training those who need to comply with the policies and creating accountability by enforcing policies (Jones-Webb, Nelson, McKee, & Toomey, 2014). In alcohol establishments, this means management needs to communicate establishment responsible beverage service policies to servers, ensuring the servers are trained to follow the policies. Management then needs to follow up with the training by enforcing the establishment policies. Approximately half of the participating general managers indicated that they communicate establishment policies to servers before the servers’ first shift. Even fewer general managers reported having procedures in place to ensure their servers are not serving alcohol to obviously intoxicated customers. Our results indicate that general managers are confident in their own skills dealing with obviously intoxicated customers, yet they have not communicated to their staff how to handle similar situations. Regular staff meetings can be conducive to discussing issues related to responsible beverage service and policies, yet only 36% of the general managers surveyed reported conducting staff meetings at least monthly.
Larger establishments (i.e., larger number of servers and/or managers) were more likely to have written policies than establishments with a smaller number of servers and managers. Establishments with four or more managers were also more likely to hand out those policies to staff before their first shift. This could indicate that smaller establishments need a more formalized process of policy development and implementation. Management training programs that focus on improving general managers’ overall skills and confidence to develop, or adopt, and fully implement establishment policies to promote responsible alcohol service may create more sustainable effects than current training programs. Since general managers with less experience in the industry were less likely to have the confidence in themselves to cut off intoxicated customers, effective management training may be particularly important for newer general managers and for those who manage smaller establishments.
General managers who perceived a high likelihood of establishments being cited for overservice of alcohol were more confident in their own ability to deal with an intoxicated customer, more likely to have communicated procedures for their servers on how to cutoff intoxicated customers and more likely to strongly agree that they always support servers’ decisions to cut off intoxicated customers. According to deterrence theory (Bushway & Reuter, 2008; Paternoster, 2010), individuals are more likely to comply with laws if they perceive there is a high certainty of facing consequences for noncompliance. To increase compliance with state laws prohibiting alcohol service to obviously intoxicated patrons, increased law enforcement targeting overservice of alcohol may be needed.
There are limitations that need to be considered when interpreting these data. This was a cross-sectional study with a limited number of general manager characteristics, making it difficult to make strong conclusions. Although this study is a good starting point for identifying general manager characteristics and associated practices, future studies should expand the number of manager characteristics to get a broader idea of the influence they may have, and perhaps further examine how manager characteristics/policies vary across different types of establishments, such as corporate versus independently owned bars/restaurants. All of the data gathered from the manager surveys was self-reported; participants may have given socially desirable responses. They may have over – or under – reported their views when stating their opinions as well as characteristics such as turnover rates, number of servers and managers, and their experience level. All data in this study were based on the general managers/establishments who participated in the eARM training program—and only 40% of the eligible establishments participated. General managers who refused to participate may have different characteristics from our participants. However, in a previous study we found that participating establishments were not different from non-participants on most characteristics (Fabian et al., 2005).
Despite these limitations, results from this exploratory study still provide useful information in the development of future interventions (e.g., training programs; increased enforcement within establishments) and research studies. Buy-in from management is imperative to proper implementation and sustainability of responsible beverage service policies and practices within bars and restaurants (Howard-Pitney, Johnson, Altman, Hopkins, & Hammond, 1991; McKnight, 1987). Customizing RBS management-level training to cater to the needs and the characteristics of individual general managers may lead to stronger policies and more sustainable practices. After policies have been adopted and properly implemented, enforcement of policies by management may reinforce the need for continued adherence to policies and training of staff. RBS training that promotes strong establishment policies may be an important part of a comprehensive community-level approach to reducing excessive alcohol use and related problems.
Acknowledgments
We would like to thank William Baker, who managed all data, and all manager survey participants.
This research was supported by a grant from the National Institute of Alcohol Abuse and Alcoholism (R01AA018169-01A1; T. Toomey, Principal Investigator).
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