title: Illegal alcohol sales to obviously intoxicated patrons at licensed establishments.
abstract: BACKGROUND
  Early studies assessing propensity of alcohol sales to underage youth found that, before intervention, likelihood of licensed alcohol establishments selling alcohol to underage youth was 50% or higher across many communities. Community-wide interventions successfully lowered underage alcohol sales rates in several communities. Across studies assessing propensity for alcohol sales to obviously intoxicated patrons, sales rate estimates ranged from 58% to 85% for on-premise establishments (e.g., bars). No previous studies have assessed likelihood of alcohol sales to obviously intoxicated patrons in off-premise establishments (e.g., liquor stores). One goal of this study was to assess propensity for illegal alcohol sales to obviously intoxicated patrons at on- and off-premise establishments. Another goal was to assess whether server and/or establishment characteristics were related to the likelihood of illegal sales. Results may inform future interventions to reduce illegal alcohol sales at licensed alcohol establishments.
  
  
  METHODS
  Trained actors attempted to purchase alcohol while acting out signs of obvious intoxication at a census of on- and off-premise alcohol establishments (n = 372) in 11 communities. The outcome variable was whether an establishment sold alcohol to a buyer. Independent variables included age and gender of server/clerk, type of establishment, area, exterior maintenance, type of license, and time of purchase attempt. Bivariate and multivariate analyses were conducted.
  
  
  RESULTS
  Seventy-nine percent of the establishments sold alcohol to a buyer (83% and 76% at off- and on-premise establishments, respectively). Servers/clerks who appeared younger than age 31 and off-premise establishments were significantly more likely than older appearing servers and on-premise establishments to sell alcohol to buyers.
  
  
  CONCLUSIONS
  The likelihood of alcohol sales to obviously intoxicated patrons in licensed alcohol establishments is very high. Interventions to reduce illegal alcohol sales to intoxicated patrons are needed.
authors.affiliation: School of Public Health, Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA. toomey@epi.umn.edu
authors.forename: Traci L
authors.initials: TL
authors.lastname: Toomey
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Wagenaar
authors.forename: Darin J
authors.initials: DJ
authors.lastname: Erickson
authors.forename: Linda A
authors.initials: LA
authors.lastname: Fletcher
authors.forename: William
authors.initials: W
authors.lastname: Patrek
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Lenk
mesh_terms: D000328:Adult; D000434:Alcoholic Beverages / Q000191:economics; D000435:Alcoholic Intoxication; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008004:Licensure / Q000191:economics / Q000331:legislation & jurisprudence*; D008297:Male; D040541:Marketing / Q000191:economics / Q000331:legislation & jurisprudence*; D016017:Odds Ratio