1. Increasing compliance with alcohol service laws in a developing country: intervention trial in the Kingdom of Bhutan.
- Author
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Dorji G, DeJong W, Bor J, Bachman DeSilva M, Sabin L, Feeley FR, Udon P, Wangchuk N, Wangdi U, Choden T, Gurung MS, Chogyel T, Wangchuk D, and Kypri K
- Subjects
- Alcoholic Intoxication, Bhutan, Education, Feedback, Humans, Licensure legislation & jurisprudence, Alcohol Drinking legislation & jurisprudence, Alcoholic Beverages, Commerce legislation & jurisprudence, Developing Countries, Law Enforcement methods, Underage Drinking legislation & jurisprudence
- Abstract
Aim: Bhutan is a low-middle income country that, like many others, experiences significant alcohol-related harm and low compliance with laws restricting availability and promotion. This study assessed changes in compliance of alcohol outlets with sales restrictions following a multi-sector programme aimed at improving this., Design: Pre-post design with covert observation of service practices., Setting: Thimphu, Bhutan, June-November 2013. Alcohol is not permitted for sale except from 1 to 10 p.m. Wednesday-Monday. Serving minors (< 18 years old) or intoxicated patrons is illegal., Participants: Seventy-one outlets selected randomly from all 209 on-premises outlets in downtown Thimphu., Intervention: Multi-sector programme involving visits to outlets, education of owners and staff, a toolkit and implementation checks., Measurements: Ten mystery-shopper visits were made to each outlet both before and after the intervention. We assessed compliance in five purchasing scenarios: (1) before 1 p.m., (2) after 10 p.m., (3) on Tuesdays and (4) shoppers who appeared to be underage or (5) intoxicated. Changes in compliance rates were assessed using multi-variable logistic regression models., Findings: Overall compliance increased from 20 to 34% [difference: 14%; 95% confidence interval (CI) = 7-22%]. Improvement was found in refusals of service before 1 p.m.: 10-34% (difference(adj) = 24%; 95% CI = 12-37%) and on Tuesdays: 43-58% (difference(adj) = 14%; 95% CI = 1-28%). Differences in refusal to serve alcohol: after 10 p.m. (difference(adj) = 15%; 95% CI = -8 to 37%); to underage patrons (difference(adj) = -5%; 95% CI = 14 to 4%); and to intoxicated patrons (difference(adj) = 7%; 95% CI = -7-20%) were not statistically significant. Younger servers, stand-alone bars and outlets permitting indoor smoking were each less likely to comply with the alcohol service laws., Conclusion: A multi-sector programme to improve compliance with legal restrictions on serving alcohol in Bhutan appeared to have a modest effect but even after the programme, in two-thirds of the occasions tested, the laws were broken., (© 2015 Society for the Study of Addiction.)
- Published
- 2016
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