title: Cross-sectional measures and modelled estimates of blood alcohol levels in UK nightlife and their relationships with drinking behaviours and observed signs of inebriation.
abstract: BACKGROUND
  Management of nightlife in UK cities focuses on creating safe places for individuals to drink. Little is known about intoxication levels as measuring total alcohol consumption on nights out is complicated by early evening interviews missing subsequent consumption and later interviews risking individuals being too drunk to recall consumption or participate at all. Here we assess mixed survey and modelling techniques as a methodological approach to examining these issues.
  
  
  METHODS
  Interviews with a cross sectional sample of nightlife patrons (n = 214) recruited at different locations in three cities established alcohol consumption patterns up to the point of interview, self-assessed drunkenness and intended drinking patterns throughout the remaining night out. Researchers observed individuals' behaviours to independently assess drunkenness. Breath alcohol tests and general linear modelling were used to model blood alcohol levels at participants' expected time of leaving nightlife settings.
  
  
  RESULTS
  At interview 49.53% of individuals regarded themselves as drunk and 79.43% intended to consume more alcohol before returning home, with around one in ten individuals (15.38% males; 4.35% females) intending to consume >40 units (equal to 400 mls of pure alcohol). Self-assessed drunkenness, researcher observed measures of sobriety and blood alcohol levels all correlated well. Modelled estimates for blood alcohol at time of going home suggested that 71.68% of males would be over 0.15%BAC (gms alcohol/100 mls blood). Higher blood alcohol levels were related to drinking later into the night.
  
  
  CONCLUSIONS
  UK nightlife has used substantive health and judicial resources with the aim of creating safer and later drinking environments. Survey and modelling techniques together can help characterise the condition of drinkers when using and leaving these settings. Here such methods identified patrons as routinely getting drunk, with risks of drunkenness increasing over later nights. Without preventing drunkenness and sales to intoxicated individuals, extended drinking hours can simply act as havens for drunks. A public health approach to nightlife is needed to better understand and take into account the chronic effects of drunkenness, the damages arising after drunk individuals leave city centres and the costs of people avoiding drunken city centres at night.
authors.affiliation: Centre for Public Health, Liverpool John Moores University, 5th Floor Kingsway House, Hatton Garden, Liverpool, L3 2AJ, UK. m.a.bellis@ljmu.ac.uk
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
authors.forename: Karen
authors.initials: K
authors.lastname: Hughes
authors.forename: Zara
authors.initials: Z
authors.lastname: Quigg
authors.forename: Michela
authors.initials: M
authors.lastname: Morleo
authors.forename: Ian
authors.initials: I
authors.lastname: Jarman
authors.forename: Paulo
authors.initials: P
authors.lastname: Lisboa
mesh_terms: D000428:Alcohol Drinking / Q000097:blood* / Q000523:psychology; D000435:Alcoholic Intoxication / Q000097:blood* / Q000523:psychology; D001944:Breath Tests / Q000379:methods; D003430:Cross-Sectional Studies; D004327:Drinking Behavior / Q000187:drug effects*; D000431:Ethanol / Q000097:blood* / Q000494:pharmacology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011998:Recreation / Q000523:psychology*; D013997:Time Factors; D006113:United Kingdom
chemical_list: D000431:Ethanol
references.citation: Drug Alcohol Depend. 2009 Jun 1;102(1-3):41-8
references.pmid: 19250775
references.citation: Addiction. 2002 Jul;97(7):901-7
references.pmid: 12133129
references.citation: Subst Use Misuse. 2006;41(5):653-68
references.pmid: 16603453
references.citation: BMJ. 2006 Mar 11;332(7541):605-7
references.pmid: 16528088
references.citation: J Stud Alcohol. 1991 Jul;52(4):302-10
references.pmid: 1875701
references.citation: Alcohol Alcohol. 2007 Nov-Dec;42(6):629-34
references.pmid: 17660522
references.citation: Addiction. 2009 Jan;104(1):4-9
references.pmid: 19133882
references.citation: Aust N Z J Public Health. 1996 Jun;20(3):290-5
references.pmid: 8768420
references.citation: Forensic Sci Med Pathol. 2007 Mar;3(1):33-9
references.pmid: 25868887
references.citation: J Stud Alcohol. 2005 Jan;66(1):130-8
references.pmid: 15830913
references.citation: Addiction. 2008 Jan;103(1):60-5
references.pmid: 17996008
references.citation: Alcohol Clin Exp Res. 2005 Sep;29(9):1672-6
references.pmid: 16205367
references.citation: Psychol Addict Behav. 2001 Dec;15(4):310-6
references.pmid: 11767262
references.citation: Br J Dermatol. 2009 Nov;161 Suppl 3:40-5
references.pmid: 19775356
references.citation: Addiction. 2007 Mar;102(3):377-80
references.pmid: 17298644
references.citation: Emerg Med J. 2006 Jan;23(1):12-7
references.pmid: 16373796
references.citation: Drug Alcohol Depend. 2008 Mar 1;93(3):191-6
references.pmid: 17945437
references.citation: J Stud Alcohol Drugs. 2009 Mar;70(2):206-14
references.pmid: 19261232