Methods: Two communities—Monroe County, NY, and Cleveland, OH—participated in a demonstration program and evaluation. The intervention integrated outreach and responsible beverage service (RBS) training; targeted enforcement; and, as necessary, implemented corrective actions by the enforcement agency to a random sample of identified problem bars. The immediate goal of the RBS/enforcement program was to reduce the practice of over-serving and serving obviously intoxicated individuals in bars and restaurants in each community. The long-term goal was to reduce impaired driving arrests and impaired driving traffic crashes by drivers aged 21 to 34. For the evaluation, data were collected on serving practices, bar patron intoxication, drinking and driving, and other alcohol-related harm from intervention and control bars or treatment and comparison communities, depending on the nature of the outcome.
Results: Overall, there were indications in both intervention communities that RBS training plus enforcement reduced the incidence of bar patron intoxication (and potential impaired driving). In Monroe County, NY, the percentage of intervention bar patrons who were intoxicated decreased from 44% to 27% and the average blood alcohol concentration of patrons decreased from .097 g/dL to .059 g/dL. In Cleveland, OH, the percentage of pseudo-intoxicated patrons who were denied service in the intervention bars increased from 6% to 29%. It appears that when bar managers and owners are aware of the program and its enforcement and servers are properly trained in RBS, fewer patrons become highly intoxicated and an effort is made to deny service to obviously intoxicated patrons.
Conclusions: RBS training, followed up with visible and sustained enforcement, may be an important strategy to combat impaired driving and other injuries associated with excessive drinking. The cumulative evidence in the evaluation points to a positive effect in reducing intoxication of bar patrons. More widespread implementation in communities, although not easily accomplished, could have an effect not only on impaired driving but also on other harm attributed to alcohol.