title: Environmental factors in drinking venues and alcohol-related harm: the evidence base for European intervention.
abstract: OBJECTIVE
  Reducing alcohol-related harm in young people is a major priority across Europe. Much alcohol use and associated harm in young people occurs in public drinking environments. This review aims to identity environmental factors in drinking establishements that are associated with increased alcohol consumption and associated harm and to understand the extent of study in this area across Europe.
  
  
  METHODS
  A systematic literature search identified studies that had explored associations between physical, staffing and social factors in drinking environments and increased alcohol use or alcohol-related harm.
  
  
  RESULTS
  Fifty-three papers were identified, covering 34 studies implemented in nine countries. Most studies had been implemented in non-European countries and many had collected data more than a decade prior to the review. The majority had used observational research techniques. Throughout the studies, a wide range of physical, staffing and social factors had been associated with higher levels of alcohol use and related harm in drinking environments. Factors that appeared particularly important in contributing to alcohol-related problems included a permissive environment, cheap alcohol availability, poor cleanliness, crowding, loud music, a focus on dancing and poor staff practice. However, findings were not always consistent across studies.
  
  
  CONCLUSIONS
  Drinking establishments, their management and the behaviours of the young people who use them vary widely across Europe. While international research shows that environmental factors in drinking settings can have an important influence on alcohol-related harm, there is currently a scarcity of knowledge on the relevance and impacts of such factors in modern European settings. Developing this knowledge will support the implementation of strategies to create drinking environments in Europe that are less conducive to risky drinking and alcohol-related harm.
authors.affiliation: Centre for Public Health, Liverpool John Moores University, Liverpool, UK. k.e.hughes@ljmu.ac.uk
authors.forename: Karen
authors.initials: K
authors.lastname: Hughes
authors.forename: Zara
authors.initials: Z
authors.lastname: Quigg
authors.forename: Lindsay
authors.initials: L
authors.lastname: Eckley
authors.forename: Mark
authors.initials: M
authors.lastname: Bellis
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.forename: Amador
authors.initials: A
authors.lastname: Calafat
authors.forename: Matej
authors.initials: M
authors.lastname: Kosir
authors.forename: Ninette
authors.initials: N
authors.lastname: van Hasselt
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D000434:Alcoholic Beverages / Q000009:adverse effects*; D000435:Alcoholic Intoxication / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D003441:Crowding / Q000523:psychology; D003615:Dancing / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D005260:Female; D019649:Food Industry / Q000193:education / Q000458:organization & administration*; D040261:Harm Reduction; D006801:Humans; D008029:Lighting / Q000009:adverse effects; D008297:Male; D009622:Noise / Q000009:adverse effects; D010541:Permissiveness; D012307:Risk Factors; D012931:Social Environment; D014754:Violence / Q000517:prevention & control / Q000523:psychology*; D055815:Young Adult