Association between Nightlife Goers' Likelihood of an Alcohol Use Disorder and Their Preferred Bar's Closing Time: A Cross-Sectional Observational Study in Perth, Australia

Infrahealth politics: Leveraging bartenders' expertise in alcohol management - An ethnography

BACKGROUND AND AIMS

Despite WHO recommendations, the percentage of persons treated for Alcohol Use Disorder (AUD) is still low. The ever-increasing burden of alcohol intoxication cases on emergency services underscores the necessity for innovative approaches to treat individuals with AUD and to improve harm reduction strategies. Bars are often frequented by individuals with AUD who are not under observation by medical or social services. Recognizing that understanding the social contexts surrounding alcohol consumption is essential for harm reduction, this study examined the often overlooked yet important role of bartenders in implementing informal harm reduction strategies.

METHODS

We conducted an ethnographic study between March and October 2023 in 33 bars in Marseille, France. Combining participant observation with semi-structured interviews, 38 bartenders (23 men and 15 women) were purposively sampled. We investigated the harm reduction strategies employed by bartenders, identified potential barriers to these professionals being able to increase harm reduction efforts, and proposed novel harm reduction strategies that these professionals and healthcare professionals could implement.

FINDINGS

Bartenders skillfully manage situations of collective overindulgence to maintain a secure environment for customers. They mediate conflict through acts that sometimes go against the bar's financial interests, including moderating customers' alcohol consumption. Occasionally, they also provide support to patrons beyond commercial obligations (accommodation, finding work). In this multifaceted public health role, they balance hospitality with risk management.

CONCLUSIONS

Bartenders play an 'infrahealth role', reducing risks associated with alcohol consumption outside the formal framework of public health. Their harm reduction intervention ranges from adjusting beverage offerings to preventing conflicts. Acknowledging that grassroots stakeholders such as bartenders contribute to tackling AUD, and strengthening the collaboration of health professionals and local authorities with these stakeholders, could help promote safer and more responsible alcohol consumption practices.

Correction: Gilmore et al. Association between Nightlife Goers' Likelihood of an Alcohol Use Disorder and Their Preferred Bar's Closing Time: A Cross-Sectional Observational Study in Perth, Australia. Int. J. Environ. Res. Public Health 2021, 18, 13040

In the original publication [...].

Association between Bar Closing Time, Alcohol Use Disorders and Blood Alcohol Concentration: A Cross-Sectional Observational Study of Nightlife-Goers in Perth, Australia

Introduction and aims: Associations between bar trading hours, a government lever for controlling alcohol availability, nightlife-goer intoxication levels and their likelihood of alcohol use disorder (AUD) have not been explored. We investigated whether: (i) participant AUD was associated with blood alcohol concentration (BAC); and, (ii) any association between AUD and BAC was moderated by participant preferred bar (i.e., venue spent most time at) closing time. Design and methods: A cross-sectional observational study using a sample of nightlife-goers who went out drinking in Perth, Western Australia, on weekends in 2015-16. Participants who reported alcohol use that night and spent most time in a bar (n = 667) completed street intercept surveys including AUDIT-C (n = 459) and provided a breath sample to estimate BAC (n = 651). We used gender-specific multinomial logistic regression models to explore associations between participant AUDIT-C score (1−4, lower risk; 5−7, hazardous; 8−12, active AUD), preferred bar type (standard vs. late closing time based on absence or presence of an extended trading permit) and BAC (male: 0−0.049, 0.05−0.099, ≥0.1 g/100 mL; female: 0−0.049, 0.05−0.079, ≥0.08 g/100 mL). Results: Males with active AUD (RR = 3.31; 95% CI 1.30−8.42; p = 0.01) and females with hazardous/active AUD (RR = 9.75; 95% CI 2.78−34.21; p < 0.001) were both more likely to have high-range BAC than their counterparts typically drinking at lower risk. We also found preferred bar type moderated the association between AUDIT-C score and BAC for some males but no females. Males with active AUD and high-range BAC were less likely to prefer late closing bars than males usually drinking at lower risk and high-range BAC (RR = 0.12; 95% CI 0.02−0.96; p = 0.046). Discussion and conclusions: Our study provides evidence of positive associations between AUD and acute intoxication among nightlife-goers and on the moderating effect of bar closing times among males.