Search

Objective: In 2017 the Northern Territory (NT) government re-introduced the Banned Drinker Register (BDR) to address the high rates of alcohol related harm. This paper aims to evaluate whether trends in assault, maltreatment and sentinel injuries in children and adolescents were associated with the re-introduction of the BDR, in the context of other local interventions such as police officers stationed in bottle shops being partially removed, Police Auxiliary Liquor Inspectors, and the introduction of a minimum unit price of alcohol., Method: Interrupted time series analysis was used to assess monthly trends in emergency department presentations and inpatient hospital admissions for assault, maltreatment and sentinel injuries between January 2014 and December 2019 in the regions of Greater Darwin, Alice Springs, and Katherine., Results: A significant step increase after the introduction of the BDR in emergency department presentations for assault and maltreatment was present when examining the three regions combined (β = 7.65, 95 % CI = 2.15, 13.16). However, this was not present at the individual community level. Results across a range of other models pointed towards null effects of the BDR introduction., Conclusions: The current study found that the re-introduction of the BDR had minimal impact on rates of assault, maltreatment, or sentinel injuries in children and adolescents. To ensure long-term harm mitigation from alcohol use, a combination of evidence informed alcohol policies that address the price and availability of alcohol in a comprehensive framework, along with measures which address the underlying social determinants of unregulated drinking and health more broadly will assist in reducing alcohol related harm in both children and adults., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. Ryan Baldwin is supported by Deakin University Research Services through an Australian Government Research Training Program Scholarship. Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Queensland government, Northern Territory government, and Australian Drug Foundation, travel and related costs from Australasian Drug Strategy Conference. Kerri Coomber currently receives funding from Cancer Council Western Australia. Debbie Scott receives grant funding from Google.org, the Australian Institute of Health and Welfare, the Commonwealth Department of Health and the Victorian Department of Health and Human Services., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Sexual harm within nightlife settings is a pervasive global concern; however, little is known about the nature of available interventions. The current study aims to review the literature on the nature and effectiveness of nightlife-related sexual harm interventions. A systematic literature search of six databases was conducted to identify records that were published between 1970 and June 2023 and reported approaches that aimed to reduce or prevent nightlife-related sexual harm. Records were included if they theorized, discussed, or evaluated an intervention, prevention or response strategy; however, individual safety strategies were excluded. Results were categorized according to intervention type. Thirty-five peer-reviewed journal articles and 16 gray literature records were identified. The most common nightlife-related sexual harm intervention strategies covered by the literature included targeted policies, laws, and regulations, bystander interventions, and awareness-raising campaigns. Literature in the area is increasing, with the majority of the articles (77.1%) being published in the previous six years; however, there are very few interventions that have been critically evaluated (22.9%). Promising areas for intervention include targeted alcohol regulations (e.g., lockout policies), venue-level policies, and environmental interventions. However, an increase in rigorous evaluative practices is urgently required to ensure future interventions are based on sound theoretical work and empirical evidence., (© 2024. The Author(s).)

Objective: With same day online alcohol sales increasing, there is a need to study their regulation. Test purchasing of alcohol home delivery was conducted to measure compliance with regulations for identification checks and unattended deliveries in two Australian jurisdictions (Perth, Western Australia and Geelong, Victoria), which have differing regulations., Method: Alcohol orders for same day or rapid (<2 hours) delivery on Friday and Saturday nights were made by research assistants aged 18-24 years in Perth (n=34) and Geelong (n=29). An observation checklist was used to record the delivery interaction, with a specific focus on checking of photo identification at time of delivery and whether deliveries were left unattended., Results: Average time from order to delivery for rapid deliveries was less than one hour in both sites (Perth = 50 minutes; Geelong = 36 minutes). More than 20% of deliveries were made without an identification check in both sites (Perth = 24%; Geelong = 21%)., Conclusions: This pilot study showed alcohol can be delivered to the home within one hour, and not all deliveries include an identification check at point of delivery. These findings indicate a need for policies that empower regulators and police to undertake 'mystery shopper' monitoring to reduce potential harms and improve compliance with alcohol delivery policy.

Background: During 2017-18, the Northern Territory (NT) introduced a Banned Drinker Register (BDR) and Minimum Unit Price (MUP) NT-wide; Police Auxiliary Liquor Inspectors (PALIs) in three regional towns; and restrictions on daily purchases/opening hours (DPOH) in one regional town. The BDR is an individual-level alcohol ban; MUP is a pricing policy; and PALIs enforce bans on restricted areas at takeaway outlets. This study examines the impact of these policies on adult domestic and family violence (DFV)., Methods: We examined DFV assaults and breaches of violence orders from January 2014 - February 2020 using interrupted time series models for NT, Greater Darwin, Katherine, Tennant Creek, and Alice Springs. To account for increasing numbers of individuals on the BDR we tested two timepoints (Sept 2017, March 2018)., Findings: Following DPOH, assaults (78 %) and alcohol-involved assaults (92 %) decreased in Tennant Creek. After PALIs, assaults (79 %) in Tennant Creek, and breaches (39 %) and alcohol-involved breaches (58 %) in Katherine decreased. After MUP, assaults (11 %), alcohol-involved assaults (21 %) and alcohol-involved breaches (21%) decreased NT wide. After MUP/PALIs in Alice Springs, alcohol-involved assaults (33 %), breaches (42 %), and alcohol-involved breaches (57 %) decreased. BDR (Sept 2017) found increases in assaults (44 %) and alcohol-involved assaults (39 %) in Katherine and assaults (10%) and alcohol-involved assaults NT-wide (17 %). There were increases of 21 %-45 % in breaches NT-wide, in Darwin, Katherine, and Alice Springs. Following March 2018 found increases in assaults (33 %) and alcohol-involved assaults (48 %) in Katherine. There were increases - from 20 % to 56 % - in breaches in NT-wide, Katherine, and Alice Springs., Conclusion: PALIs and DPOH were associated with some reductions in DFV; the BDR was associated with some increases. The upward trend commences prior to the BDR, so it is also plausible that the BDR had no effect on DFV outcomes. Although MUP was associated with reductions in the NT-wide model, there were no changes in sites without cooccurring PALIs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: In September 2017 the Northern Territory Government of Australia introduced a banned drinker register (BDR) to mitigate the high levels of alcohol-related harm within the Northern Territory. The current study aimed to examine the impact of the Northern Territory BDR on youth (aged <18 years) using police recorded assault data., Methods: Interrupted time-series models were used to assess monthly trends in assaults and alcohol-related assaults perpetration and victimisation in the regions of Greater Darwin, Alice Springs and Katherine between January 2014 and December 2019., Results: Examining the three regions combined, after the re-introduction of the BDR a significant step decrease in police recorded youth assault perpetration (β = -1.67) and a significant step increase in police recorded youth assault victimisation (β = 1.40) was identified. However, no significant effects were identified at the individual region level., Discussion and Conclusions: Findings suggest that restricting alcohol consumption in high-risk adults through the BDR had a limited immediate effect in police recorded youth assaults. Individual level or contextual factors may have influenced both immediate and long-term impacts of the BDR, and as such, future policy design needs to support and empower community leaders across the policy development and implementation process. A wider evaluation of the BDR currently underway may provide additional understanding behind the mechanisms that underpin alcohol-related harm in the Northern Territory., (© 2024 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Introduction: Variation in alcohol availability is an important driver of levels of consumption and harm, with recent increases in online alcohol home delivery use expanding availability. There is limited research on the impacts of these changes and the characteristics of consumers who use alcohol home delivery., Methods: This study presents findings from an online survey (n = 465) of Western Australian adults who had purchased alcohol for home delivery within the past 6 months. Analyses compared high-risk and low-risk drinkers on use of, and exposure to, alcohol home delivery., Results: Compared to low-risk drinkers, high-risk drinkers were significantly more likely to make more frequent online purchases (odds ratio 5.42), utilise same day delivery (odds ratio 2.91) and purchase through specialised online-only retailers (odds ratio 2.69). High-risk drinkers also reported receiving deliveries while intoxicated more often (odds ratio 11.62), and ordering alcohol for delivery to continue a current drinking session (odds ratio 7.47). High-risk drinkers also received advertising for alcohol home delivery more frequently (odds ratio 1.60) than low-risk drinkers. High-risk drinkers also ordered larger quantities of alcohol than low-risk drinkers (M = 49 vs. 32 standard drinks)., Discussion and Conclusions: Findings from this study indicate that these services are popular with high-risk drinkers and potentially undermine other policy efforts to reduce drinking. Within Australia, stronger legislation (such as mandatory delay between order and delivery) and monitoring (e.g., test purchasing for compliance) are recommended., (© 2023 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Objective: To investigate the medium-term impacts of the COVID-19 pandemic on violence-related offences in Australia, and whether there was evidence of a 'dual pandemic' of family violence in addition to COVID-19., Methods: Autoregressive Integrated Moving Average time series were conducted to analyse publicly available violent crime statistics data from January 2017 to November 2021. Population rates of homicide, sexual, domestic and non-domestic assault were assessed across each Australian state and territory, with the effects of COVID-19 being modelled using the average monthly World Health Organization COVID-19 stringency rating for each jurisdiction., Findings: All jurisdictions in Australia showed increasing or stable domestic assault trends over the past decade, which were not significantly impacted by COVID-19, nor by the subsequent lockdowns. Non-domestic assaults demonstrated a significant, negative relationship with the stringency index for each jurisdiction, except Western Australia. There was no significant change in the rates of homicide or sexual assault across Australia in relation to COVID-19., Conclusion: Overall, there was no evidence of a 'dual pandemic' in Australia, and whilst domestic assaults continue to increase across the country, non-domestic assaults showed a notable but brief decline. However, these have returned to levels at least as high as pre-COVID-19 and some states show a continuing upward trend. The findings also suggest that alcohol availability may have played a role in continuing high violence numbers. Given the ongoing increasing and high levels of family violence in Australia, revised conceptual frameworks and interventions are indicated., (© 2023. Crown.)

Background: The COVID-19 pandemic, and associated public health measures, had a marked impact on a number of health and wellbeing outcomes, including alcohol use and violence. Current literature presents a mixed view of the impact of the pandemic on violence trends. The current study utilises police offence data from a region of northern England to examine the impact of lockdowns, and subsequent relaxation of restrictions, on trends in violent offences., Methods: Time series analyses using seasonal auto-regressive integrated moving average (SARIMA) modelling was used to investigate the impacts of the COVID-19 public health measures on weekly offence trends from April 1 2018 to March 20 2021. Additionally, pre-pandemic data were used to forecast expected trends had the pandemic not occurred. These expected trends were then compared to actual data to determine if the average levels of violence were outside the forecasted expectations. Overall violence and six subtypes (violence with and without injury, sexual offences including rape, domestic violence, and alcohol-related violent offences) were examined., Results: Overall, the observed trend in police recorded violent offences demonstrated fluctuating patterns in line with commencement and easing of public health restrictions. That is, offence numbers declined during lockdowns and increased after relaxation of restrictions. However, the majority of observed values fell within the expected range. This broad pattern was also found for subtypes of violent offences., Conclusions: While violent crime trends demonstrated fluctuations with lockdowns, and subsequent easing of restrictions, these changes were not demonstrably larger than expected trends within this English region, suggesting that a sustained amplification in violence was not observed within this data. However, it is important to acknowledge the high levels of violence reported in this region across the study period, which should be used as a key driver for investing in long-term approaches to violence prevention. Given the extent of unreported violence generally, and that victims/survivors may come into contact with other support services (without reporting to the police), it is vital that policy and practice decisions take a holistic approach, considering a broad range of data sources., (© 2023. The Author(s).)

Objective: From October 1, 2018, the Northern Territory (NT) of Australia introduced a minimum unit price (MUP) for alcohol of AU$1.30 per standard drink. The MUP was introduced to address the high alcohol consumption rates and harms within the NT. This study aimed to investigate the unique short-term impact of the MUP on alcohol-related assaults across the NT, for the NT overall and separately for four key regions (Darwin and Palmerston, Alice Springs, Katherine, and Tennant Creek); which allowed for the consideration of differences in concurrent alcohol interventions and population (e.g., Alice Springs had Police Auxiliary Liquor Inspectors (PALIs) introduced on October 1, 2018, whereas Darwin and Palmerston only had the MUP introduced in this period). PALIs effectively equate to a police officer being stationed in every off-premise liquor vendor., Method: Using data from January 2013 to September 2019, interrupted time series (ITS) analyses assessed the short-term impact of the MUP on the monthly rate of police-recorded alcohol-related assaults., Results: A 14% reduction ( B = -3.07 [-5.40, -0.74], p < .010) was found for alcohol-related assault offenses per 10,000 in Darwin/Palmerston. Significant reductions were also noted in Alice Springs and the NT overall, although PALIs are likely to have contributed to these reductions in addition to the MUP., Conclusions: This short-term impact warrants longer-term follow-up to determine whether the reductions in alcohol-related assaults following the introduction of MUP are maintained, and the extent to which assault rates are influenced by other alcohol-policy interventions in the NT.

Objective: This theoretical review examines prior theories that aim to explain the disproportionate amount of violence in Nighttime Entertainment Precincts (NEPs) and proposes a comprehensive model that links violence to policy and environmental changes., Method: To understand why this violence occurs and better inform prevention and intervention, a theoretical review using a "people" in "places" approach was conducted. This perspective considers the precursors of violence both at the individual level and among a group within a shared environment., Results: Prior public health, criminology, and economic theories that aim to explain why violence occurs in NEPs provide a limited perspective, each only capturing part of the story. Further, prior theories fall short of demonstrating how policy and environmental changes in an NEP can influence the psychological determinants of aggression. When unified in a social-ecological framework, they can provide a more holistic explanation of violence in NEPs. We propose the Core Aggression Cycle (CAC) model, which draws from the prior theories examining violence in NEPs, and psychological theories of aggression. The CAC model is a proposed basis for unifying future research across disciplinary discourses., Conclusions: The CAC provides a clear conceptual framework that has the capacity to incorporate multiple previous and future theoretical perspectives on how alcohol policy and the environment influence violence within nightlife spaces. The CAC can be used by policy makers to establish new policy, critically evaluate existing policy, and determine whether policy adequately addresses the underlying mechanisms that produce violence in NEPs.

Objective: Assess the impact of Northern Territory alcohol policy changes to ED utilisation at Royal Darwin-Palmerston Regional Hospitals., Methods: Interrupted time series analysis explored trends in monthly ED attendance numbers and the proportion self-discharging prior to policy changes (September 2016 to August 2017) and after three sequential interventions; the Banned Drinker Register, introduced September 2017, system changes to the sobering shelter, January 2018, and the minimum unit floor price (MUFP), October 2018. A targeted cohort of attendances transported by police as an alternative to the sobering shelter or police watch-house when there is a medical concern was selected as they are likely impacted by all policy changes., Results: Police transported 1176 patients on 2070 occasions from September 2016 to March 2019. There was a downward trend in monthly attendances across the study period, with no significant change attributable to the Banned Drinker Register, a significant step decrease with the sobering shelter changes (P = 0.002), and a significant gradual decrease following the MUFP (P = 0.025). This represented an immediate decrease of 3.82 attendances per month/10 000 residents following the sobering shelter changes and a gradual decrease of 0.92 attendances/10 000 residents after the MUFP. Rates of self-discharge were high, 45% in the pre-intervention phase, decreasing to 28% following the MUFP but this trend did not reach significance with any intervention., Conclusion: The sequential introduction of broad sweeping alcohol policy changes introduced by the Northern Territory government was associated with significant reductions in ED utilisation. The proximity of the introduction of interventions creates difficulties identifying individual policy influence., (© 2022 Australasian College for Emergency Medicine.)

Pre-drinking is a common practice for young people prior to entering a night-time entertainment precinct (NEP), and is associated with numerous harms, such as increased experience of physical aggression and drink driving. The relationship between both impulsivity traits such as negative urgency, positive urgency and sensation seeking and conformity to masculine norms, and number of pre-drinks remains under-researched. The current study aims to explore whether level of negative urgency, positive urgency, sensation seeking, or conformity to masculine norms is associated with the number of pre-drinks consumed prior to entering a NEP. Participants included patrons aged under 30 years that were systematically selected for street surveys in Fortitude Valley and West End NEPs, Brisbane, Australia; and completed a follow-up survey in the week following (n = 312). Generalized structural equation modelling was used to fit five separate models with a negative binomial regression using a log link function, adjusting for age and sex. Postestimation tests were conducted to identify any indirect effects via an association between pre-drinking and enhancement motives. The standard errors were bootstrapped for the indirect effects. We found direct effects for sensation seeking. Indirect effects were present for Playboy norms, Winning norms, positive urgency and sensation seeking. While these findings provide some evidence that impulsivity traits can influence the number of pre-drinks an individual consumes, the findings suggest that some traits are more likely to be related to overall alcohol consumption and that pre-drinking is a unique type of alcohol consumption with distinct predictors that require further investigation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: From October 2018, the Northern Territory (NT) government introduced a minimum unit price (MUP) for alcohol of $1.30 per standard drink. We assessed industry claims that the MUP penalised all drinkers by examining the alcohol expenditure of drinkers not targeted by the policy., Methods: Participants recruited by a market research company using phone sampling (n=766, 15% consent fraction) completed a survey in 2019, post-MUP. Participants reported their drinking patterns and their preferred liquor brand. Estimated annual alcohol expenditure for each participant was calculated by collating the cheapest advertised price per standard drink of their preferred brand pre-and-post-MUP. Participants were grouped as consuming within the Australian drinking guidelines ("moderate") or over them ("heavy")., Results: Based on post-MUP drinking patterns, moderate consumers had an average annual alcohol expenditure of AU$327.66 (CIs=325.61, 329.71) pre-MUP, which increased by AU$3.07 (0.94%) post-MUP. Heavy consumers had an estimated average annual alcohol expenditure of AU$2898.82 (CIs=2877.06, 2920.58) pre-MUP, which increased by AU$37.12 (1.28%)., Conclusions: The MUP policy was associated with an increase of AU$3.07 in alcohol annual expenditure for moderate consumers., Implications for Public Health: This article provides evidence that counters the alcohol industry's messaging, enabling an evidence-based discussion in an area dominated by vested interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Alcohol harms are often determined using a proxy measure based on temporal patterns during the week when harms are most likely to occur. This study utilised coded Australian ambulance data from the Victorian arm of the National Ambulance Surveillance System (NASS) to investigate temporal patterns across the week for alcohol-related ambulance attendances in 2019. These patterns were examined by season, regionality, gender, and age group. We found clear temporal peaks: from Friday 6:00 p.m. to Saturday 3:59 a.m. for both alcohol-involved and alcohol-intoxication-related attendance, from Saturday 6:00 p.m. to Sunday 4:59 a.m. for alcohol-involved attendances, and from Saturday 5:00 p.m. to Sunday 4:49 a.m. for alcohol-intoxication-related attendances. However, these temporal trends varied across age groups. Additionally, hours during Thursday and Sunday evenings also demonstrated peaks in attendances. There were no substantive differences between genders. Younger age groups (18-24 and 25-29 years) had a peak of alcohol-related attendances from 7:00 p.m. to 7:59 a.m. on Friday and Saturday nights, whereas the peak in attendances for 50-59 and 60+ years was from 5:00 p.m. to 2:59 a.m. on Friday and Saturday nights. These findings further the understanding of the impacts of alcohol during different times throughout the week, which can guide targeted policy responses regarding alcohol use and health service capacity planning.

Introduction: Alcohol-related harms place a significant burden on the Australian economy and health-care system. The current study aims to: (i) explore the relationship between blood alcohol concentration (BAC) and self-estimated blood alcohol concentration (EBAC); and (ii) determine whether BAC underestimation is related to an increased risk of experiencing physical aggression, verbal aggression, drink driving, ejection from a venue or refusal of service., Methods: Patron street surveys were conducted in four night-time entertainment precincts (NEP) across Queensland, Australia, between June 2016 and November 2018. Participants (N = 2144) reported on their EBAC and recent negative or harmful experiences in NEPs. BAC was measured via a breathalyser. Paired samples t tests were conducted to determine if patrons' BAC and EBAC were significantly different. Logistic regressions were conducted to examine whether BAC underestimation is a significant predictor of harm and negative outcomes., Results: Analyses identified a small, significant difference between patron's BAC and EBAC. Patrons with a low BAC were more likely to overestimate their BAC, while patrons with higher BACs were more likely to underestimate their BAC. Moderately intoxicated patrons had the most precise BAC estimations. Patrons with a high BAC and who underestimated their intoxication level were more likely to have been recently ejected from licensed venues, compared to accurate estimators or over-estimators., Discussion and Conclusions: Overall, patrons are poor evaluators of their own intoxication level, which may have implications for their experiences in NEPs. The findings highlight the need for improved BAC education for patrons., (© 2022 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: The objective of this study was to explore key informant attitudes towards the 'Last Drinks at 3am' legislation in Safe Night Precincts in Queensland, Australia., Method: Sixty-six interviews were conducted with a range of stakeholders including licensees, law enforcement and frontline health professionals. Interviews were semi-structured and analysed using thematic analysis. Key informants responded to questions regarding their experiences of, and opinions about, the last drinks legislation., Results: Key informants reported a range of experiences around the impact of last drinks restrictions, including reduced staffing costs and patron-related problems within licensed venues. While some venues reported that their businesses lost money, others reported no change in income or that they changed their business model to compensate. Law enforcement and health professionals reported a range of benefits including reduced alcohol-related anti-social behaviour, drunkenness and injury., Conclusions: The majority of key informants reported that the last drinks legislation reduced harm, while having minimal detrimental impact on business., (© 2022 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Background: Experiences of unwanted sexual attention (UWSA) are commonplace within nightlife environments. While typically associated with aggression perpetration, literature has suggested that a history of childhood corporal punishment (CCP) may also be related to experiences of victimisation in nightlife environments. The current exploratory study aims to examine the associations between experiences of UWSA victimisation and a history of CCP, trait aggression, and conformity to masculine norms (Playboy and Winning), for males and females separately., Method: Street intercept interviews in the Brisbane inner-city entertainment precincts were used to measure demographic details and participants' breath alcohol concentration. Online follow-up surveys were used to record participants' experiences of UWSA on the night of interview, history of CCP, and self-reported rates of trait aggression and conformity to masculine norms. The final sample consisted of 288 females, as there were not sufficient male UWSA experiences for analysis., Results: Approximately 20% of female nightlife patrons experienced some form of UWSA victimisation. Logistic regression analyses identified that after controlling for age and intoxication, a history of CCP, trait aggression and masculine norm conformity were unrelated to experiences of UWSA for female respondents., Conclusions: The current study found that individual factors were unrelated to experiences of UWSA, indicating that simply being in the nightlife environment, especially as a female, increases the risk of UWSA victimisation. Understanding and exploring social and environmental risk factors, rather than individual factors, is needed to prevent victimisation in nightlife environments.

Background: Alcohol related violence in night-time entertainment precincts (NEPs) is a significant public health concern. Studies suggest characteristics including venue density, bar hopping and permissive social norms facilitate violence in NEPs. Yet, we have a limited understanding of how individual drinking occasions progress within NEPs and how location sequence is associated with the propensity to experience violence in these spaces., Methods: In this study we apply sequence analysis and logistic regression to examine the association between location sequences and experiences of violence among a sample of NEP patrons (N=387)., Results: We find that individuals who stay out longer and visit a greater number of unique location types are more likely to experience a violent event. We also find that attending a 'non-venue' pre-event such as a private party, gathering, sporting or celebratory event, is associated with elevated risk experiencing violence during a night out., Conclusion: The findings offer important insights into the dynamic context in which risky drinking occasions may emerge and suggest that the context and location in which pre-drinking occurs should be considered in future research., Competing Interests: Declarations of Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, WA Police, Cancer Council Victoria, Central Australian Aboriginal Congress, Northern Territory government, Australian Rechabites Foundation, Northern Territory Primary Health Network, Lives Lived Well, Queensland government and Australian Drug Foundation, travel and related costs from Queensland Police Service, Queensland Office of Liquor Gaming and Racing, ABC, and the Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm. Kerri Coomber has received funding from the ARC, Queensland Government, Northern Territory Government, FARE, Australian Rechabites Foundation, Lives Lived Well, and Victorian Commission for Gambling and Liquor Regulation., (Copyright © 2022 Elsevier B.V. All rights reserved.)

There is substantial evidence supporting the association between alcohol license density and violent crime. However, the impact of different types of alcohol licenses on intimate partner and family violence is sparse. We explored the associations between access to alcohol outlets, and family and intimate partner violence using paramedic clinical records, given this service is often the first to respond to acute crises. Coded ambulance attendance data from 694 postcodes in Victoria, Australia, from July 1, 2016 to June 30, 2018 where alcohol or another drug, mental health or self-harm associated with family or intimate partner violence was indicated were examined. A hybrid model of spatial autoregressive and negative binomial zero-inflated Poisson-based count regression models was used to examine associations with alcohol outlet density and socioeconomic factors. We found that access to a liquor license outlet was significantly associated with family violence-related attendances across all types of outlets, including on-premise (late night) licenses ( β = 1.73, SE: 0.18), restaurant licenses ( β = 0.83, SE: 0.28), and packaged liquor licenses ( β = 0.62, SE: 0.06). Our results demonstrate a significant relationship between alcohol-related harms in the context of family violence and provides evidence of the relationship between alcohol-related family violence in both victims and perpetrators. The findings of this study highlight the need for public health interventions such as licensing policy and town planning changes to reduce these harms by restricting alcohol availability.

Introduction: The Banned Drinker Register (BDR) was reintroduced in the Northern Territory (NT) in September 2017. The BDR is a supply reduction measure and involves placing people who consume alcohol at harmful levels on a register prohibiting the purchase, possession and consumption of alcohol. The current study aims to evaluate the impacts of the reintroduction of the BDR, in the context of other major alcohol policy initiatives introduced across the NT such as Police Auxiliary Liquor Inspectors and a minimum unit price for alcohol of US$1.30 per standard drink., Methods and Analyses: The Learning from Alcohol (policy) Reforms in the Northern Territory project will use a mixed-methods approach and contain four major components: epidemiological analysis of trends over time (outcomes include health, justice and social welfare data); individual-level data linkage including those on the BDR (outcomes include health and justice data); qualitative interviews with key stakeholders in the NT (n≥50); and qualitative interviews among people who are, or were previously, on the BDR, as well as the families and communities connected to those on the BDR (n=150). The impacts of the BDR on epidemiological data will be examined using time series analysis. Linked data will use generalised mixed models to analyse the relationship between outcomes and exposures, utilising appropriate distributions. Qualitative data will be analysed using thematic analysis., Ethics and Dissemination: Ethics approvals have been obtained from NT Department of Health and Menzies School of Health Research Human Research Ethics Committee (HREC), Central Australia HREC and Deakin University HREC. In addition to peer-reviewed publications, we will report our findings to key organisational, policy, government and community stakeholders via conferences, briefings and lay summaries., Competing Interests: Competing interests: PM has received funding from Australian Research Council (ARC) and Australian National Health and Medical Research Council (NHMRC), grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education (FARE), Cancer Council Victoria, Central Australian Aboriginal Congress, Northern Territory Government (NTG), Australian Rechabites Foundation, Northern Territory Primary Health Network (NTPHN), Lives Lived Well, Queensland Government and Australian Drug Foundation (ADF), travel and related costs from Queensland Police Service, Queensland Office of Liquor Gaming and Racing and the Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm. KC has received funding from the ARC, Queensland Government, Northern Territory Government, FARE, Australian Rechabites Foundation, Lives Lived Well, and Victorian Commission for Gambling and Liquor Regulation. JS has received funding from ARC, NHMRC, ADF, NTPHN, NTG, Australian Government Department of Health, National Centre for Student Equity in Higher Education, Movember and NT Mental Health Coalition. He is the Deputy Chair of the NTPHN Community Advisory Council and has acted as an unpaid Expert Witness to the NT Liquor Commission. ML has received funding from the ARC, NHMRC, FARE, VicHealth, the Western Australian Mental Health Commission, Systembolaget (the Swedish alcohol monopoly), The Sax Institute and The Victorian Responsible Gambling Foundation. He is a board member of the Australian Rechabites Foundation. MS has received funding from the NTG, the NTG Community Benefit Fund which receives money through a hypothecated tax on Electronic Gambling Machines in the NT. He has also received money from the NHMRC, the NSW Office of Liquor, Gaming and Racing, the Victorian Responsible Gambling Foundation, and Gambling Research Australia. SG has received funding from ARC and NTG. RR has received funding from ARC, NHMRC, FARE, VicHealth, the US Institutes of Health and the World Health Organisation. CJCW has received funding from ARC, NHMRC, FARE, VicHealth, Australian Government Department of Health, Alcohol and Drug Foundation, Gandel Philanthropy, Victorian Transport Accident Commission, the Jack Brockhoff Foundation and the Australian Government eSafety Commissioner. SD has received funding from ARC and NTG. KEG has received funding from the ARC, NHMRC, Medical Research Futures Fund (MRFF), Australian Government Department of Health, Australian Government National Indigenous Australian Agency, Perpetual (Ramaciotti Foundations), Cardiovascular Research Network & National Heart Foundation, The Lowitja Institute. SC is supported by an Australian Government Research Training Program (RTP) Scholarship and a Menzies School of Health Research Top-Up Scholarship DS has received funding from the ARC, Victorian Department of Health, Australian Institute of Health and Welfare, Traffic Accident Commission., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Children are often exposed to increased rates of secondary harm such as physical harm, motor vehicle incidents, maltreatment, and neglect because of others' or their own alcohol consumption. Alcohol supply reduction, or alcohol control policies, are often enacted to mitigate alcohol harms within the community. The current systematic narrative review aims to synthesise recent literature that examines how alcohol supply reduction policies impact the physical health, mental health, and offending behaviour of children and adolescents., Methods: Eight databases and grey literature sources were systematically searched, and results were synthesised by policy under evaluation. Twenty-one peer reviewed articles and ten grey literature articles were included after screening of 7,135 original articles. Included articles examined the alcohol control policies of the minimum legal drinking age, price control, and trading restrictions, with the most common outcomes under evaluation being related to the physical health or offending behaviour of adolescents., Results: Overall, the current review identified that the impact of alcohol policy on children and adolescents varied depending on the policy type, policy environment and assessed outcome. Common limitations within the literature include inability to control for covariates, use of alcohol related outcomes unsuitable to children and adolescents, and use of cross-sectional data and regression-discontinuity analysis in lieu of actual policy changes., Conclusions: The current review highlights the need to further evaluate the impact of actual alcohol-related policy changes on children and adolescents., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

This study explores two approaches to measuring coercive controlling behaviors (CCBs)-counting how many different CCB types and examining the frequency of each CCB experienced-to examine their utility in explaining the relationship between CCBs and physical intimate partner violence (IPV). Australian women aged 18-68 years ( n = 739; M age = 31.58, SD age = 11.76) completed an online survey. Count and frequency CCB approaches yielded similar significant associations with increased physical IPV. Both approaches suggest that frightening behaviors in particular are significantly indicative of also experiencing physical IPV; however, when you count CCB types, public name-calling becomes important, whereas when you examine the frequency of each CCB type, jealousy/possessiveness becomes important. These findings suggest differential utility between measures of CCBs, which examine the frequency of specific CCB types and which count CCB types, and that both approaches are useful in understanding how coercion and control relate to physical violence within intimate relationships.

Family and domestic violence (FDV) is a significant social issue that causes major harm across Australia. Alcohol has been identified as a contributing factor to FDV, and as such increased understanding of the role of alcohol in police-reported FDV incidents may provide the basis for developing specific clinical and forensic approaches. This study aims to identify the key correlates of alcohol-related FDV within police-reported FDV incidence. Data sourced from several states and territories across Australia were used to profile demographic and personal factors involved in police-reported FDV incidents, and to identify the types of incidents involving alcohol. For each state, three separate binary regressions were conducted for family violence, intimate partner violence, and FDV incidents in which alcohol was involved. Between 24% and 54% of FDV incidents reported to police were classified as alcohol-related. Although there appeared to be an association between relative socioeconomic disadvantage and an incident being alcohol-related, this association varied across states. Where victim and offender data were available, offenders were significantly more likely to be alcohol-affected than victims. Alcohol-related FDV incidents were also twice as likely to involve severe physical violence including injuries that were life threatening, as well as an increased likelihood of recidivism. This study demonstrates that alcohol plays a substantial role in police-reported FDV across Australia. It also demonstrates that other factors such as drug use, breach of orders, and repeat offending are associated with alcohol involvement across family violence and intimate partner violence.

Background: High-risk intoxication, trait aggression and conformity to masculine norms are associated with increased risk of barroom aggression; however, less is understood regarding the factors associated with victimization in the night-time environment., Objective: This study aimed to explore the influence of childhood physical abuse, high-risk intoxication, conformity to masculine norms and trait aggression on physical and/or verbal victimization in the night-time environment., Participants and Setting: A sample of N = 490 patrons aged 18-50 years (M = 23.02, SD = 5.89, 58.8% female) were recruited in Fortitude Valley and West End district, Queensland., Method: Participants completed a street interview, including breathalyser, and a follow-up online survey asking about experiences of aggression on the night of interview, experiences of childhood physical abuse and psychosocial correlates., Results: For males, but not females, childhood physical abuse (OR = 3.98) increased the risk of physical and/or verbal victimization. Conformity to the masculine norm of Winning (OR = 0.21) was protective against physical and/or verbal victimization for males, and trait aggression (OR = 1.51) was significantly associated with increased risk of physical and/or verbal victimization for females., Conclusions: These findings add to the growing literature surrounding the long-term impacts of childhood physical abuse, demonstrating experiences of childhood physical abuse are significantly associated with victimization in the night-time economy. The current findings should be taken into consideration when constructing public policy or directed interventions, to help reduce aggression and violence in the night-time economy., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Exposure to parental violence can have devastating consequences for children, including significant personal, social, and academic problems. The present study determined the situational factors that are associated with children's exposure to intimate partner violence (IPV) incidents. To examine whether these factors were unique to child witnesses' presence at IPV incidents, we also determined the factors that are associated with children's exposure to family violence (FV) and other family member witnesses' exposure to IPV incidents. Participants responded to an online panel survey investigating the role of alcohol and other drugs in family and domestic violence incidents in Australia. Nine hundred fifty-two respondents reported an IPV incident and 299 reported an FV incident; they provided details about their most recent incident. Results showed that child witnesses were more likely to be present during IPV incidents if the incident took place at home (odds ratio [OR] = 3.10), if a similar incident had occurred previously (OR = 1.66), if drugs were involved (OR = 1.60), and if a police report was made (OR = 2.61). There was some overlap with the other witness and violence combinations: The presence of a police report also predicted child witnesses' presence at FV incidents, and a home location also predicted other family member witnesses' presence at IPV incidents. These results enhance our understanding of the situations in which children might witness IPV incidents; future research is needed to determine whether these situational factors can be used to judge risk.

Drug use has been shown to interact in complex ways with the occurrence and prevalence of family and domestic violence (FDV), with illicit drug use being associated with an increased risk for FDV. The current study aims to extend upon the literature by investigating the role of illicit drugs in intimate partner violence (IPV), family violence (FV), and other violence (violence between people other than partners or family) within a representative Australian sample ( n = 5,118). Participants were recruited through an online survey panel and completed an online self-report survey assessing the role of alcohol and other drugs on violence, with a specific focus on FDV. Binary logistic regression showed that respondents who reported having used any illicit drug in the past 12 months (with or without alcohol use) had over three times the odds of experiencing any violence in the past 12 months (OR = 3.18, 95% confidence interval (CI) = [2.25, 4.48]) compared with those not using illicit drugs. Furthermore, drug involvement in FDV (IPV or FV) was significantly more likely than other violent incident types (OR = 1.65, 95% CI = [1.25, 2.19]). For the most recent FDV incident, age group was the only significant demographic predictor of drug involvement at this incident; younger age groups were over twice as likely to report drug involvement than those over 65 years of age. Drug involvement at the most recent FDV incident was also associated with over twice the odds of injury (OR = 2.38, 95% CI = [1.67, 3.38]) and significantly greater negative life impact. The findings that drug use increases both the risk for and impact of FDV indicate the need for policy that advocates for interventions addressing both drug use and violence in combination.

Introduction: On 1 July 2016, stage 1 of the Tackling Alcohol-Fuelled Violence (TAFV) policy was introduced in Queensland, Australia and included restricted alcohol service to 03:00 in dedicated entertainment precincts (safe night precincts or SNPs). During stage 2 (from 1 February 2017), the number of extended trading permits (i.e. trading until 05:00) per venue were reduced; and during stage 3 (from 1 July 2017), networked identification scanners were mandated for late-night venues. We aim to examine whether patron drinking behaviours in two key SNPs changed significantly following stages 2 and 3., Methods: The study design was repeated cross-sectional, with three data collection (policy) stages. Patrons street surveys were conducted in Fortitude Valley (n = 2066) and Cairns (n = 1021) SNPs between July 2016 and November 2018. Linear or negative binomial regressions were conducted to examine changes in three key outcomes: blood alcohol concentration (BAC) reading, proportion of pre-drinkers and number of pre-drinks., Results: We found no significant difference in BAC reading, proportion of pre-drinkers or number of pre-drinks at stages 2 and 3 of the policy compared to baseline in Fortitude Valley. In Cairns, we found significant reductions in patron BAC at stage 3 of the policy, and female BAC at stages 2 and 3 compared to baseline; while the proportion of females pre-drinking significantly reduced by half in stage 2., Discussion and Conclusions: Despite evidence of some reductions in alcohol consumption, high levels of intoxication remain, suggesting harm reduction may be more difficult to achieve in these drinkers., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

This closing commentary to the special section presents an overview of the Queensland Alcohol-related violence and Night-Time Economy Monitoring evaluation findings in comparison to those from other jurisdictions where similar interventions have been implemented (such as Sydney and Newcastle), and especially with previous studies that have used similar evaluation methodologies, such as the Dealing with Alcohol and the Night-Time Economy study. Overall, the articles documented promising reductions in alcohol-related harm, building on the existing evidence base for multi-pronged interventions in entertainment districts. Importantly, this is the first comprehensive investigation to also look at impacts on nightlife-related business and findings demonstrated, that there were improvements for many businesses. There are substantial policy implications for Queensland and other jurisdictions (nationally and globally) wanting to reduce late night alcohol-related harm in entertainment districts., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

This commentary introduces the special section on the outcomes of the Queensland Alcohol-related violence and Night-time Economy Monitoring project and outlines the political and policy context of the interventions put in place under the Queensland government's Tackling Alcohol-Fuelled Violence strategy. The development of the strategy was informed by alcohol policy initiatives trialled in other major Australian cities over the past two decades. The articles in this special section examine the impact of the Tackling Alcohol-Fuelled Violence policy stages on alcohol-related harms and local economies across selected entertainment precincts (Safe Night Precincts). A rich array of data were utilised, including administrative health and justice data, data reflective of nightlife trading (i.e. foot traffic data, ID scanner data and live music performances) and street surveys. Findings have implications for research, policy and practice and demonstrate the need for comprehensive evaluations that can accommodate the complexities of modern alcohol policy in Australia., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: Key elements of the Queensland Government's Tackling Alcohol Fuelled Violence (TAFV) policy included the introduction of mandatory identification (ID) scanners and reduced trading hours for licensed venues located within Safe Night Precincts (SNP). These measures raised concerns among licensed venue owners and other key stakeholders regarding the potential negative impact of the policy on business trade and nightlife. Using multiple data sources, this paper examines the impact of the TAFV policy on nightlife and trade in three Queensland SNPs: Fortitude Valley, Surfers Paradise and Cairns., Methods: Data from ID scanners (2017-2019), foot traffic counters (2017-2019) and counts of liquor licences issued (2015-2019) were used to measure the policy's impact on the number of patrons and licensed venues within SNPs. Joinpoint regression and auto-regressive integrated moving average models were developed to examine changes in these measures over time., Results: No significant changes were observed in the number of ID scans over time, although Surfers Paradise showed a 0.13% reduction during high alcohol hours. Foot traffic counts from Fortitude Valley showed no significant impact of the policy on the number of patrons in the area during high-alcohol hours. The number of commercial hotel licenses increased in all three regions, and commercial other-bar licenses increased in all regions except Surfers Paradise SNP where numbers remained stable., Discussion and Conclusions: Patterns in trading and the number of patrons within SNPs were mostly stable or increasing following the implementation of the TAFV policy beyond normal fluctuations., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Introduction and Aims: In July 2016, the Queensland government introduced the Tackling Alcohol-Fuelled Violence policy, with some amendments over the subsequent 12 months. Key measures included restricting alcohol sales to 3 am in safe night precincts (SNPs), limiting the annual number of extended trading permits (i.e. trading until 5 am) and introducing mandatory networked identification scanners. We examined the policy impact on the number of serious assaults across all combined SNPs and in five major SNPs: Fortitude Valley, Cairns, Surfers Paradise, Toowoomba and Townsville., Design and Methods: Using police data (July 2009-June 2019), we examined the impact of the policy on serious assaults during high-alcohol hours (high-alcohol hours; 8 pm-6 am, Friday and Saturday), employing time series methods., Results: Across all SNPs there was no significant change in the number of serious assaults during overall high-alcohol hours, but a significant 49% decrease in the monthly number of serious assaults between 3 am and 6 am on Friday/Saturday. A significant decrease in the monthly count of serious assaults during high-alcohol hours and specifically 3 am-6 am on Friday/Saturday was evident in Fortitude Valley SNP (52%), and during high-alcohol hours in Toowoomba SNP (43%)., Discussion and Conclusions: Although results were mixed, there was evidence of some promising reductions in alcohol-related violence in SNPs. It is likely that factors such as extended trading permits (venues not closing at 3 am), continued drinking in some venues and 24-h trading in casinos have reduced the potential impacts seen elsewhere., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Introduction and Aims: In an attempt to reduce alcohol-related harm in night-time entertainment precincts, the Queensland state government (Australia) introduced the Tackling Alcohol-Fuelled Violence strategy in July 2016, including restrictions on late-night service of alcohol and-later-compulsory ID scanners at venues. In this article, we examined the impact of these changes on emergency department (ED) presentations and hospital admissions for alcohol-related harm., Design and Methods: We used data on ED presentations (July 2009-June 2019) and hospital admissions (July 2009-December 2018). Interrupted time series models using seasonal auto-regressive integrated moving average methods were developed to test the impact of the policy change on presentations for alcohol intoxication, any injury or maxillofacial fractures, and admissions for rates of assault-related injuries or maxillofacial fractures. Analyses were conducted using state-wide Queensland data with a sub-analysis focussing on major Brisbane hospitals., Results: The introduction of 3 am last drinks and mandatory ID scanners had no significant impact on most outcome measures, either across the state or within Brisbane. State-wide, there was a significant decline in ED injury presentations following the introduction of mandatory ID scanners., Discussion and Conclusions: The introduction of the Tackling Alcohol-Fuelled Violence strategy in Queensland Safe Night Precincts was potentially associated with a small reduction in injury presentations to EDs. The lack of other impacts may relate to the relative lack of specificity in health system data, which challenges in the implementation of the Tackling Alcohol-Fuelled Violence policies or other local factors., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: In July 2016, the Queensland Government introduced the Tackling Alcohol-Fuelled Violence (TAFV) policy to address alcohol-related harm in entertainment precincts [safe night precincts (SNP)]. Additional measures were introduced in February and July 2017. We aim to examine the impact of the policy on Queensland Ambulance Service call-outs in Fortitude Valley, Surfers Paradise, all 15 SNP suburbs combined and statewide., Methods: Auto-regressive integrated moving average (ARIMA) models and seasonal ARIMA (SARIMA) models were developed to test the impact of TAFV policy stages on monthly number of ambulance call-outs during high alcohol hours (HAH; Friday and Saturday nights, 20:00-05:59) over an 8-year period (July 2011-June 2019)., Results: The average number of monthly call-outs in HAH reduced by 26.2% in Fortitude Valley, 21.1% in Surfers Paradise and 4.3% in all 15 SNP suburbs combined. In Fortitude Valley, there was a significant decline in the monthly number of call-outs between 00:00 and 02:59 and across all HAH combined when examining the cumulative effect of the policy stages; and significant declines between 03:00 and 05:59 after each stage and cumulatively. Across the 15 SNP suburbs combined, there was a significant decline in call-outs between 03:00 and 05:59 after the third policy stage (July 2017). There were no significant declines in Surfers Paradise or statewide., Discussion and Conclusions: Overall, the introduction of the TAFV policy stages in Queensland had a limited effect on ambulance call-outs during HAH. However, there were some notable declines in HAH ambulance call-outs in some of the state's key nightlife suburbs., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: Night-time entertainment precincts (NEP) are the site of a disproportionate amount of alcohol-related violence, injuries and anti-social behaviour. To combat this the Queensland government introduced patron bans in October 2014, giving police the power to exclude individuals from NEPs and preventing patrons from remaining in or entering the designated area or from designated premises for the ban duration. Mandatory identification scanners within licensed venues were also introduced, which are used to enforce patron bans. This study aimed to evaluate the effectiveness of police-issued 10-day patron bans for preventing alcohol-related violence or anti-social behaviour occurring within NEPs during high-alcohol hours., Methods: Queensland's largest NEPs; Brisbane central business district, Fortitude Valley and Surfers Paradise central business district; were examined. Time-series autoregressive integrated moving average analyses were used to estimate the influence of 10-day patron bans on police-recorded serious assaults, common assaults and good order offences. Analyses controlled for the introduction of relevant policy and identification scanners., Results: The number of police-issued patron bans did not significantly predict changes in serious assault, common assault or good order offence trends the weekend following the ban (within the 10-day period)., Discussion and Conclusions: The current study was unable to find evidence indicating that 10-day patron bans reduced alcohol-related harms experienced in Queensland's largest NEPs in the short term. Further research needs to be conducted examining other types of patron bans, particularly longer bans issued in other jurisdictions or by licensees, and whether bans change individual's behaviour., (© 2020 Australasian Professional Society on Alcohol and other Drugs.)

Aims: Venue capacity has been proposed as a factor associated with increased number of violent incidents on-premises, though no specific research has demonstrated this association, and instead has tended to focus on the relationship between crowding and aggression. The aim of current paper is to investigate the association between venue capacity and the number of violent incidents on-premises., Methods: Venue capacity data (the maximum capacity listed on the liquor license) were obtained for all venues in central Melbourne from 2010 until 2016. These data were then matched with police-recorded on-premises assaults that occurred within high-alcohol hours (Friday and Saturday 8 pm-6 am) inside the venue., Results: Analyses were conducted on 5729 venue-years (yearly assault counts per venue, per year) across central Melbourne. Compared with venues that have a maximum capacity of between 0 and 100 patrons, venues with higher capacities have increasingly more recorded assaults. Venues with maximum capacities between 501 and 1000 are 6.1 times more likely to have an assault recorded compared with venues with a maximum capacity between 0 and 100. Further, each additional high-alcohol hour that a venue can be open for is associated with a 72% increase in the number of recorded assaults., Conclusions: Greater venue capacity was found to be strongly associated with an increased risk of violent incidents for any given venue. This was further exacerbated by late-night trading which substantially adds to the risk of assaults inside the venue., (© 2021 by the Research Society on Alcoholism.)

Background: Night-time entertainment precincts (NEPs) are clusters of higher-risk on-licence venues, that pose a significant burden on health and social order services. Outlet density and trading hours are two of the most well researched contributors to alcohol availability within NEPs; increases in outlet density and late-night trading hours within NEPs have been independently associated with increased assaults. This is the first study to examine both factors across cities to predict alcohol-related assaults., Methods: Licensing data were used to investigate the effect of outlet density and trading hours on police recorded serious assaults in nine NEPs (9 cross-sectional units) across Queensland from January 2010 to July 2018 at monthly intervals (102 longitudinal units). Multi-level models were used to determine i) whether precinct-level trading hours moderated the relationship between outlet density and serious assaults; and ii) the impact of outlets closing before 12am, 3am, and 5am on serious assaults., Findings: The positive relationship between outlet density and assaults was stronger in precincts with trading hours ending at 5am compared to 3am (IRR = 1.01, p = 0.03). The amount of venues closing before 12am was associated with reduced numbers of assaults (IRR = 0.97, p = 0.04), while venues closing between 12:01am-3am and 3:01am-5am were associated with increased assaults (IRR = 1.02, p<0.01; IRR = 1.01, p = 0.02)., Conclusions: Late night service of alcohol creates more harm in areas of high outlet density, whereas early closing venues in areas where outlet density is low is associated with reduced number of assaults. This relationship should be taken into account in the development of future alcohol policies., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: The Northern Territory (NT) Government introduced a minimum unit price (MUP) of $1.30 per standard drink (10g pure alcohol) explicitly aimed at reducing the consumption of cheap wine products from October 2018. We aimed to assess the impact of the NT MUP on estimates of beverage-specific population-adjusted alcohol consumption using wholesale alcohol supply data., Methods: Interrupted time series analyses were conducted to examine MUP effects on trends in estimated per capita alcohol consumption (PCAC) for cask wine, total wine and total alcohol, across the NT and in the Darwin/Palmerston region., Results: Significant step decreases were found for cask wine and total wine PCAC in Darwin/Palmerston and across the Northern Territory. PCAC of cask wine decreased by 50.6% in the NT, and by 48.8% in Darwin/Palmerston compared to the prior year. PCAC for other beverages (e.g. beer) were largely unaffected by MUP. Overall, PCAC across the Territory declined, but not in Darwin/Palmerston., Conclusion: With minimal implementation costs, the Northern Territory Government's MUP policy successfully targeted and reduced cask wine and total wine consumption. Cask wine, in particular, almost halved in Darwin/Palmerston where the impact of the MUP was able to be determined and considering other interventions. Implications for public health: Implementation of a minimum unit price for retail alcohol sales is a cost-effective way to reduce the consumption of high alcohol content and high-risk products, such as cheap cask wine., (© 2021 The Authors.)

Introduction and Aims: Street service care providers in Queensland, Australia are organisations tasked with assisting vulnerable individuals and aiding intoxicated patrons that are at risk of harm in night-time entertainment precincts (NEP). Members of these organisations patrol NEPs and provide services, such as first aid, to individuals in need. There has been no research conducted on their impact on crime, injuries and on the duties of Australian frontline service resources (e.g. police and ambulance services). This study evaluated the introduction of a single street service care in the Cairns NEP on police-recorded assaults, emergency department injury presentations and ambulance service utilisation during high-alcohol hours., Design and Methods: Police-recorded assaults (common and serious), emergency department injury presentations and ambulance attendances for the Cairns suburbs were examined. Autoregressive integrated moving average time series analyses were used to determine the impact of street service care on monthly counts for each dataset., Results: Serious assaults during high-alcohol hours significantly declined after the introduction of the support service in Cairns, with a one-month lagged impact (B = -1.66, 95% confidence interval -3.02, -0.30). No other significant impact on common assaults, emergency department injury presentations or ambulance attendances were found., Discussion and Conclusions: This study provides preliminary evidence that street service care may help to decrease assaults within a single NEP. However, further research investigating the impact of street services in larger cities, and determining what other roles the service may be able to play in preventing alcohol-related harm, is needed., (© 2019 Australasian Professional Society on Alcohol and other Drugs.)

Background: This study describes the frequency and characteristics of aggression and/or violence in ambulance attendances involving alcohol, illicit and/or pharmaceutical drug use in Victoria, Australia between January 2012 and January 2017., Methods: Patient characteristics, context, and substance use involvement in ambulance attendances were examined to determine associations with attendances where aggression and/or violence was recorded., Results: There were 205,178 ambulance attendances where use of alcohol, pharmaceutical drugs or illicit substances contributed to the reason for the attendance. Paramedics recorded acts of aggression and/or violence in 11,813 (5.76 %) of these attendances. Aggression/violence was more likely to be recorded in certain contexts. Compared with attendances where aggression/violence was not recorded, attendances where aggression/violence was recorded were significantly more likely to involve younger and male patients, and occur on Friday and Saturday nights. Alcohol intoxication was involved in more than half of attendances where aggression/violence was recorded, and was almost twice as prevalent as those involving illicit drug use where aggression/violence was recorded. This pattern was consistent across all hours, high-alcohol hours only, by metropolitan/regional location, and by police co-attendance., Conclusions: Aggression and violence are frequently recorded in ambulance attendances involving alcohol, pharmaceutical drugs or illicit substances, and, most often involve alcohol. This violence poses a recurring threat to the health and safety of paramedics, bystanders, and patients. Greater priority should be given to reducing alcohol-related violence through evidence-based policy measures targeting high-risk groups (e.g. young adult males) and contexts (e.g. weekends, late at night) where harm is most likely to occur., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Sharing anonymised ED data with community agencies to reduce alcohol-related injury and assaults has been found effective in the UK. This protocol document outlines the design of an Australian multi-site trial using shared, anonymised ED data to reduce alcohol-related harm., Design and Method: Nine hospitals will participate in a 36 month stepped-wedge cluster randomised trial. After a 9 month baseline period, EDs will be randomised in five groups, clustered on geographic proximity, to commence the intervention at 3 monthly intervals. 'Last-drinks' data regarding alcohol use in the preceding 12 h, typical alcohol consumption amount, and location of alcohol purchase and consumption, are to be prospectively collected by ED triage nurses and clinicians at all nine EDs as a part of standard clinical process. Brief information flyers will be delivered to all ED patients who self-report risky alcohol consumption. Public Health Interventions to be conducted are: (i) information sharing with venues (via letter), and (ii) with police and other community agencies, and (iii) the option for public release of 'Top 5' venue lists., Outcomes: Primary outcomes will be: (i) the number and proportion of ED attendances among patients reporting recent alcohol use; and (ii) the number and proportion of ED attendances during high-alcohol hours (Friday and Saturday nights, 20.00-06.00 hours) assigned an injury diagnosis. Process measures will assess logistical and feasibility concerns, and clinical impacts of implementing this systems-change model in an Australian context. An economic cost-benefit analysis will evaluate the economic impact, or return on investment., (© 2019 Australasian College for Emergency Medicine.)

Aims : This study aimed to explore the relationship between a 00:00 liquor restriction, introduced on 1 July 2016, and alcohol-related harm by examining its impact on serious assault numbers during high-alcohol hours (20:00-6:00 Friday and Saturday night), from 1 January 2009 to 30 June 2018. Methods : Two types of locations only impacted by the liquor restriction were identified: designated safe night precincts (SNPs) and other local government areas (LGAs). A times series autoregressive integrated moving average analysis was used to estimate the influence of liquor restrictions on police-recorded serious assaults in the two years following the policy introduction, for SNPs and LGAs separately. Results : Contrarily to our predictions, monthly police-recorded serious assaults did not significantly change within SNPs or LGAs following the introduction of liquor restrictions. Conclusion : The implementation of the Queensland liquor restriction did not result in a clear, unique reduction in serious assault trends. Further investigation should consider the impact of liquor restrictions in conjunction with other policy changes as public perception of restrictions and their cumulative impact may produce varied outcomes.

Introduction and Aims: Associations between substance use and aggression may be amplified by simultaneous alcohol and illicit drug use. This study aims to compare differences in involvement in past aggression between people who use different substances while accounting for broader risk propensity., Design and Methods: Self-reported data on past three-month involvement in verbal and physical aggression (victim or perpetrator) were drawn from interviews conducted in night-time entertainment districts in seven Australian cities (n = 5078). Using inverse probability of treatment weighting techniques, participants who reported alcohol versus alcohol and illicit drug use on the night of interview (including ecstasy, cannabis and other illicit stimulant subgroups) were weighted on the basis of drug use risk covariates (e.g. alcohol consumed, gender) to determine differences in involvement in aggression involvement., Results: After weighting for covariates, individuals who reported consuming any illicit drug + alcohol and ecstasy + alcohol combinations were more likely to be involved in physical (33% and 105%, respectively) and verbal (36% and 116%, respectively) aggression in the previous 3-months when compared to those who consumed alcohol only. Cannabis + alcohol and other illicit stimulant + alcohol combinations were no more likely to be involved in either forms of aggression., Discussion and Conclusions: The likelihood of having been involved in past aggressive incidents was higher among those who reported any illicit drug + alcohol and ecstasy + alcohol combinations than those who reported alcohol exclusively, after accounting for covariates. These findings highlight individuals that may benefit most from the development of tailored health promotion/preventative safety interventions in night-time settings., (© 2019 Australasian Professional Society on Alcohol and other Drugs.)

Background: Risk-based licensing (RBL) is among the more recent policy interventions to reduce alcohol-related harm in and around licensed venues. RBL sets licence fees to reflect the venue's propensity to cause harm as a means of encouraging operators to improve their practices. We assessed whether the introduction of RBL in the Australian states of Queensland and Victoria was associated with a reduction in the incidence of emergency department (ED) injury presentations., Methods: We employed an interrupted time series design using Prais-Winsten and Cochrane-Orcutt regression modelling to estimate step and slope parameters in injury incidence rates in each state. We defined the population as residents of the state, aged 15-54 years, the age group we considered most likely to be exposed to the night-time economy. To reduce noise, we confined cases to presentations during times previously identified as correlated with a high probability of alcohol involvement, namely 'high alcohol hours' (HAH). We adjusted our models for the alcopops tax, implemented shortly before RBL, and for assaults during low alcohol hours (LAH) as a proxy for other risk factors for assault., Results: RBL was not associated with an overall reduction in the incidence of ED injury presentations during HAH in Queensland (β = 0.003; 95% CI: -0.010, 0.003, p = 0.318) or Victoria (β=-0.010; 95% CI: -0.021, 0.001, p = 0.087). Post-hoc subgroup analyses showed a reduction in ED injury presentations among men aged 20-39 years in Victoria (β=-0.026; 95% CI:-0.012, -0.040, p-0.0003) but this was not replicated in Queensland., Conclusion: There was little evidence that RBL affected the incidence of ED presentations for injury. This may be due to weak financial penalties being applied to venues assessed as high-risk., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Introduction and Aims: The link between alcohol and experience of violence is well-documented, but there is a paucity of empirical research on the role of alcohol specifically in family and domestic violence (FDV) in Australia. The aim of the current study was to describe the relationship between alcohol use and FDV in the Australian population, and to examine key differences between three different types of violence: family violence, intimate partner violence (IPV) and other violence., Design and Methods: An online panel survey was conducted using a stratified random sampling design., Results: In total, 5118 respondents were included, of whom 44.5% reported experiencing violence in their lifetime, and 6.0% reported recent (past year) experience of violence. Recent violent incidents were comprised of IPV (41.8%), family violence (13.1%) and other violence (45.1%). Approximately one-third of all violent incidents experienced (either as a victim or perpetrator) were alcohol-related, and 37.8% of respondents who experienced IPV and 27.8% of those who experienced family violence reported past year heavy-episodic drinking. Alcohol use was associated with higher rates of physical violence and injury at IPV incidents. Alcohol consumed at IPV incidents was most often purchased from a supermarket liquor store (37.0%) and consumed at the respondent's home, regardless of the distance between the purchase location and incident location., Discussions and Conclusions: This study found that alcohol is frequently involved in FDV incidents, particularly IPV. Alcohol use was associated with a higher chance of physical violence and of injury at IPV incidents., (© 2019 Australasian Professional Society on Alcohol and other Drugs.)

Objective: Transporting people out of nightlife districts is often cited as a major issue associated with alcohol-related harm. The Victorian Government introduced 24-hour public transport (24hr PT) in Melbourne, Australia, on Friday and Saturday nights in January 2016. After the 1-year trial period, funding was extended for a further 4 years, at a cost of more than AU$300 million to date. The current study aimed to determine whether 24hr PT reduced harms associated with the nightlife of Melbourne and whether there has been an increased number of people using the transport and visiting Melbourne city on Friday and Saturday nights., Method: Police assault data, ambulance attendance data, crash data, public transport use data, and pedestrian counting data were analyzed to determine the impact of 24hr PT on harms in the nightlife of Melbourne, as well as changes in the number of people using public transport and attending the city., Results: There was no change from 2015 to 2016 in the number of police-recorded assaults, ambulance attendances, or crashes for the entirety of the night. There were significantly more people out in the city later in the evening, and more people using trains and trams during the 24hr PT time (i.e., 1 A.M.-5 A.M.)., Conclusions: The initiative did not decrease harm in Melbourne nightlife, in contrast to industry, government, and expert predictions. With expenditures of more than AU$300 million, the costs and benefits of this initiative require further consideration and research, especially when it is proposed in opposition to evidence-based solutions, such as closing venues earlier., Competing Interests: Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council; grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Queensland government, and Australian Drug Foundation; and travel and related costs from Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm.

Background: Assaults occur frequently in night-time entertainment precincts (NEPs), with rates typically reported using estimated resident population. However, this form of reporting does not accurately represent the number of people within the NEP at the time of an assault or potential fluctuations in density throughout the course of the night. As such, the aim of this study was to assess multiple methods of obtaining an accurate estimate of hourly foot-traffic within NEPs., Methods: The validity and reliability of three types of foot traffic counters were assessed. A passive-infrared sensor and two different types of smartphone sensor were installed at two sites in Australia from 2016 to 2018, ongoing (pilot phase: 2016-2017; validation phase: 2018). Researchers also manually counted the number of people walking past through the range of two of these sensors across the course of Friday, Saturday and Sunday nights between 8 pm to 2am., Results: Results show a similar trend between the smartphone counts, the sensor counts, and the manual counts; however there was notable variability (43%-267% compared with manual counts). Analysis showed that all measures were significantly positively correlated., Conclusion: Reliable counting of the number of people attending nightlife precincts is an important element of ongoing studies into nightlife settings and associated rates of harm. There are multiple methods of estimating fluctuations in foot traffic within a NEP, however, determining the most appropriate method to use requires consideration of the proximity of pathways in the area, budget constraints, and project aims. Of the methods tested, laptop WiFi traffic monitoring programs functioned the least consistently. Specifically designed smartphone sensors overcame this issue; however, they required dedicated power sources. The current study found infrared scanners appeared to be the most accurate across sites; additionally they functioned consistently, and were the simplest method to setup and maintain., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: This paper evaluates the impact of the AU$83 million introduction of 24-h public transport (PT) in Melbourne, Australia on Friday and Saturday nights on a sample of nightlife venues and venue patrons. This sample was selected because a primary reason for the introduction of 24 h PT was to provide a safe means of travel home for nightlife attendees., Methods: Covert venue observations (pre-post) and a convenience sample of nightlife patron interviews (post-only) were conducted to measure the impact of 24-h PT on venues and venue patrons. Specifically, the impact of 24-h PT on the proportion of people observed within venues (as rated on a 0-100% scale of venue capacity), patrons in venues showing any sign of intoxication, those who were observed to be too intoxicated to remain in the venue, patron drinking or drug taking behavior, train use, and the time and money spent in the night time economy were assessed., Results: After 24-h PT was introduced there were no significant differences overall in the proportion of people observed within venues, or significant associations with the proportion of patrons showing any sign of intoxication or proportions who were observed to be too intoxicated to remain in the venue. However, when accounting for seasonality (matching-months), observed patron intoxication increased significantly after the introduction of 24-h PT. The majority of nightlife patrons did not report a change in their pre-drinking or drug taking behavior after 24-public transport, but 44% indicated spending more time in the night time economy, 27% reported spending more money, and 56% reported increasing their train use., Conclusion: Patron reports suggest that 24-h public transport has increased the amount of time people spend in nightlife settings without obviously impacting on drinking behavior. However, supplying 24-h public transport has resulted in greater self-reported use of public transport., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Alcohol-related harm in night-time entertainment precincts (NEPs) is disproportionately high for the amount of alcohol consumed within these areas. Previous evaluations of alcohol restrictions targeting NEPs have often looked at restrictions in isolation and not attempted to create a comprehensive theoretical explanation that takes multiple restrictions into account. The aim of this review is to establish which restrictions have been adequately evaluated in previous literature, and to identify any research which may provide the basis for a theoretical model that explains the interactions between different alcohol restrictions in NEPs and their combined impact on alcohol-related-harm., Methods: A mapping review was conducted to plot evaluations of the effectiveness of different alcohol restrictions in NEPs at reducing assault and injury rates (protocol PROSPERO 2017: CRD42017069773). Six databases and 145 websites were searched, results were categorised based on the type of restrictions evaluated: Outlet density, trading hours, lockouts, price, patron bans, and drinks restrictions., Results: Forty-eight articles were identified out of 20,743 returned by the systematic search. Thirty-five of these papers were original works, and 13 reviews. Outlet density was examined in 15 of the papers, trading hours in 30, lockouts in 21, price in 2, patron bans in 7 and drinks restrictions in 15., Conclusion: No pre-existing theoretical models were identified. Outlet density, trading hours, and price restrictions all had evidence that suggested high levels of effectiveness in NEPs and would be suitable for inclusion in a theoretical model. More research is required before attempting to include lockouts, patron bans and drinks restrictions in a theoretical model. Future research should focus on establishing a theoretical model based on evidence of effective alcohol restrictions and gathering an evidence base for under-researched restrictions., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: This study aims to explore short-term changes following the introduction of alcohol restrictions (most notably 2 am to 3 am last drinks). We examined patterns of nightlife attendance, intoxication, and alcohol use among patrons shortly before and after restrictions were introduced in Fortitude Valley, Brisbane: the largest night-time entertainment precinct of Queensland., Methods: Street-intercept patron interviews were conducted in Fortitude Valley in June (n = 497) and July (n = 562) 2016. A pre-post design was used to assess changes in time spent out drinking/partying prior to the interview, time of arrival in the precinct, pre-drinking, and blood alcohol concentration (BAC)., Results: Regression models indicated that after the policy introduction, the proportion of people arriving at Fortitude Valley before 10:00 pm increased (OR = 1.38; 95% CI = 1.04, 1.82). Participants reported going out, on average, one hour earlier after the intervention (β = - 0.17; 95% CI = 0.11, 0.22). There was a decrease (RRR = 0.58; 95% CI = 0.43, 0.79) in the proportion of participants who had a high level of intoxication (BAC ≥0.10 g/dL) post-intervention. No other significant differences were found., Conclusions: Earlier cessation of alcohol sales and stopping the sale of rapid intoxication drinks after midnight was associated with people arriving in Fortitude Valley earlier. Though legislative loopholes allowed some venues to continue trading to 5 am, the proportion of people in the precinct who were highly intoxicated decreased after the restriction. Further measurement will be required to determine whether the reduction has persisted.