title: Does legislation to prevent alcohol sales to drunk individuals work? Measuring the propensity for night-time sales to drunks in a UK city.
abstract: BACKGROUND
  By measuring alcohol retailers' propensity to illegally sell alcohol to young people who appear highly intoxicated, we examine whether UK legislation is effective at preventing health harms resulting from drunk individuals continuing to access alcohol.
  
  
  METHODS
  73 randomly selected pubs, bars and nightclubs in a city in North West England were subjected to an alcohol purchase test by pseudo-drunk actors. Observers recorded venue characteristics to identify poorly managed and problematic (PMP) bars.
  
  
  RESULTS
  83.6% of purchase attempts resulted in a sale of alcohol to a pseudo-intoxicated actor. Alcohol sales increased with the number of PMP markers bars had, yet even in those with no markers, 66.7% of purchase attempts resulted in a sale. Bar servers often recognised signs of drunkenness in actors, but still served them. In 18% of alcohol sales, servers attempted to up-sell by suggesting actors purchase double rather than single vodkas.
  
  
  CONCLUSIONS
  UK law preventing sales of alcohol to drunks is routinely broken in nightlife environments, yet prosecutions are rare. Nightlife drunkenness places enormous burdens on health and health services. Preventing alcohol sales to drunks should be a public health priority, while policy failures on issues, such as alcohol pricing, are revisited.
authors.affiliation: Centre for Public Health, WHO Collaborating Centre for Violence Prevention, Liverpool John Moores University, , Liverpool, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Hughes
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
authors.forename: Nicola
authors.initials: N
authors.lastname: Leckenby
authors.forename: Zara
authors.initials: Z
authors.lastname: Quigg
authors.forename: Katherine
authors.initials: K
authors.lastname: Hardcastle
authors.forename: Olivia
authors.initials: O
authors.lastname: Sharples
authors.forename: David J
authors.initials: DJ
authors.lastname: Llewellyn
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D000434:Alcoholic Beverages / Q000191:economics* / Q000600:supply & distribution*; D000435:Alcoholic Intoxication / Q000453:epidemiology / Q000517:prevention & control*; D003132:Commerce / Q000331:legislation & jurisprudence*; D004739:England; D005260:Female; D006801:Humans; D008297:Male
keywords: ALCOHOL; PUBLIC HEALTH POLICY; SOCIAL EPIDEMIOLOGY