Responsible Beverage Service (RBS) Traci L. Toomey, PhD Professor School of Public Health University of Minnesota

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1 Responsible Beverage Service (RBS) Traci L. Toomey, PhD Professor School of Public Health University of Minnesota

2 Policy/ Program Availability Rates and Patterns of Consumption Alcoholrelated Problems

3 Alcohol Availability Influenced by Serving Practices at Alcohol Establishments Decrease availability by promoting responsible beverage service.

4 What is Responsible Beverage Service? Over consumption of alcohol is discouraged and not promoted No deeply discounted alcohol Promote alcohol-free beverages and food rather than alcohol Alcohol is not served illegally to: Individuals under age 21 Obviously intoxicated patrons

5 What is the sales rate to underage youth prior to intervention? 50% 52% 47% On-Sale Establishments Off-Sale Establishments Forster et al., 1995

6 What is the sales rate to obviously intoxicated patrons prior to intervention? 75% 83% 47% On-Sale Establishments Off-Sale Establishments Toomey, et al., 2004

7 Intervention Alcohol Sale Laws Compliance Deterrence Internal Merchant Policies ID Checking Server Training Monitoring System Server/Clerk Behavior Confiscate false ID Refuse sales to youth/intoxicated Reduce Availability Prevent Illegal Alcohol Sales Reduce Consumption & Related Problems

8 hat is Responsible Beverage Service Training Compliance-based strategy Manager training Legal requirements Setting and implementing outlet policies Server training Legal requirements Establishment policies Knowledge & skills to comply with laws

9 o reduce problems at a community or state level, we need to consider: 1) What is the most effective RBS training program? 2) How do we implement the best RBS training 3) Is RBS training sufficient to create change?

10 Are you assisting with and/or providing RBS training at the local level? A. Yes B. No C. Not sure/don t t know

11 Would you describe your RBS efforts?

12 What do RBS training programs look like in your community/state?

13 RBS Training Programs Not all equal Need to consider how to change behavior unlikely to change behavior with an hour-long video or lecture Need to consider content, skill building techniques, and how targeted audience will respond to program

14 Qualitative Assessment of Training Programs for Alcohol Servers and Establishment Managers T.L. Toomey, G. Kilian, J.P. Gehan, C.L. Perry, R. Jones-Webb, A.C. Wagenaar

15 Review of Existing Server Training Programs 24 Videotapes 15 Training packages 6 Technical reports

16 Rated Categories Legal context Social problems Establish policies Underage issues Intoxication issues Realistic Physiological Behavioral change methods Production quality Respectful of audience

17 Findings Great variation in quality No training was outstanding in every respect Few training packages focused on owners and managers No training focused exclusively on development of establishment alcohol serving policies

18 Review of Server Training Literature Not likely to prevent sales to underage Increased knowledge Change in attitudes Increase in mild intervention with intoxicated customers May decrease intoxication levels No sustained increase in refusals to intoxicated patrons Change in management policies essential

19 Results from focus groups Employees: Support external enforcement Support internal policies Frustrated by management Take pride in the work Don t benefit from serving intoxicated or underage

20 Results from focus groups Owners and Managers: Refuse to accept any responsibility No written internal policies No system for monitoring enforcement Don t know state and local alcohol laws No management training Strong fear of lawsuits Little fear of enforcement

21 What are you hearing from your local merchants regarding their interest and support for RBS?

22 PROJECT Alcohol Risk Management - Compliance-based intervention - Provide skills/motivation to comply with laws

23 Features Focus on owners and managers One-on-one consultation Focus on policy development and enforcement Establishment-specific policy manual Trainers with experience in the hospitality industry

24 Four or Five Sessions Review existing policies and practices Discuss/Select model policies Introduce selected policies at staff meeting Finalize policy selection Discuss implementation/enforcement of policies

25 Motivating factors for management Fear of liability lawsuits Price of liability insurance Fines, suspension and revocation Decrease in sales

26 Sample Internal Policies Age identification Preventing underage sales The intoxicated guest Standard serving size Internal enforcement Crowd control Advertising and promotion Regular server training Alternative transportation Alternative beverage Drinking on the job Personnel issues

27 Demonstration Project Pilot study 5 intervention bars 14 comparison bars Pre/Post outcome evaluation

28 % Decrease Pseudo-Intoxicated 46% Underage 11.5%

29 Intervention Alcohol Sale Laws Compliance Deterrence Internal Merchant Policies ID Checking Server Training Monitoring System Server/Clerk Behavior Confiscate false ID Refuse sales to youth Reduce Availability Prevent Illegal Alcohol Sales to Underage Reduce Consumption & Related Problems

30 Enforcement Compliance Checks Also called: Stings Underage youth attempts to purchase alcohol Supervised by law enforcement Warning letter sometimes sent Penalties: server and/or license holder

31 Enforcement Compliance Checks Deterrence-based intervention Specific deterrence General Key characteristics: Perceived certainty Severity Swiftness

32 Questions: Compliance Checks Do compliance checks work? Do you have to check all establishments? How long do the effects last?

33 Answers Compliance checks reduce likelihood of illegal sales On-premise establishments show an initial 17% reduction, which decreases to an 8% long-term reduction Off-premise establishments also show an initial 17% reduction, with no long-term reduction No general deterrence

34 Recommendations: Compliance Checks Check all establishments in a community One or two checks per year may not be sufficient

35 Survey #2 How frequently does your community conduct compliance checks? A. Never B. Once a year C. Twice a year D. Three-four times a year E. More than 4 times a year

36 From your experience, what are some of the barriers for conducting compliance checks?

37 If you are trying to reduce sales to underage youth, should RBS training be one of your strategies?

38 Intervention Alcohol Sale Laws Compliance Deterrence Internal Merchant Policies ID Checking Server Training Monitoring System Server/Clerk Behavior Identify signs of intoxication Refuse sales to intoxicated patrons Reduce Availability Prevent Illegal Sales to Obviously Intoxicated Patrons Reduce Consumption & Related Problems

39 A Randomized Trial to Evaluate Project ARM

40 ARM 210 agreed to voluntarily participate (81%) ARM training well received 85% (n=104) completed all 4 sessions of full ARM

41 ARM TRIAL: Purchase Rates (LS Means) Purchase Rate 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 72% 72% 69% Training 58% 80% 73% Intervention Control Baseline 1 Month 2-3 Months

42 Potential Implications -Short-term effect from a consistently implemented, intensive training program -Need to be cautious recommending training as a primary strategy to prevent illegal alcohol sales -Need to consider effects at a population level (local or state policies)

43 To reduce problems at a community or state level, we need to consider: (1) What is the most effect RBS training program? (2) How do we implement the best RBS training at the community or state level? (3) Is RBS training sufficient to create change?

44 A Qualitative Review of Server Training Laws University of Minnesota School of Public Health J. F. Mosher, JD, Senior Scientist Traci L. Toomey, PhD, Assistant Professor Eileen Harwood, PhD, Research Associate Charles Good, JD, Research Assistant Alexander Wagenaar, PhD, Professor of Epidemiology

45 Data Collection 23 states with enacted RBS laws prior to January 1, 2001 Reviewed data for each state through: RBS statutes and regulatory provisions Telephone interviews with ABC staff

46 23 State RBS Laws* 11 incentive (i.e., voluntary); 12 mandatory states Incentive: offer benefit to licensees who train staff Mandatory: require at least some employees of alcohol retail establishments to attend server training *as of January 1, 2001

47 State RBS Systems Involve at Least Five Elements Program requirements Administrative system requirements Penalty provisions (mandatory states) Benefit provisions (incentive states) Enforcement resources

48 Conclusions -Most states had weak legislation in one or more of 4 key RBS components -Effective, comprehensive legislation exists for each component in one or more states -Oregon and New Mexico had strong overall programs -Enforcement component weak in most states due to lack of resources

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50 Recommendations for RBS Programs 1. Training in all information relevant to servers association with social problems coverage of legal requirements 2. Training in behavioral change/communication techniques 3. Training for all who serve alcohol 4. Training for managers as well as servers 5. Development of management policies supportive of server practice 6. Four-hour minimum duration

51 Recommendations for RBS Administration 1. Criteria and procedures for certifying or licensing RBS training programs, and required re-certification at regular intervals. 2. Criteria and procedures for certifying or licensing training graduates, and required re-certification at regular intervals. 3. Requirements for licensee documentation of staff certification at regular intervals.

52 Recommendations for RBS Penalties 1. Graduated administrative penalties. 2. Penalties targeting training programs, licensees, and, to a lesser extent, servers.

53 To reduce problems at a community or state level, we need to consider: (1) What is the most effect RBS training program? (2) How do we implement the best RBS training at the community or state level? (3) Is RBS training sufficient to create change?

54 Survey #3 Are you rethinking the power of your RBS program? A. No B. Yes

55 For those of you reconsidering your RBS strategy, why are you doing so and what are the implications for your work?

56 Not Just Alcohol Establishments Don t forget: Community festivals Sport stadiums Music venues Non-commercial sources of alcohol!

57 University of Minnesota