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Preventing Excessive Alcohol Consumption: Responsible Beverage Service Training

Responsible Beverage Service (RBS) training programs give owners, managers, and staff of establishments that serve alcohol knowledge and skills to help them serve alcohol responsibly and fulfill the legal requirements of alcohol service.

Training programs for managers and owners most often provide guidance on implementation of service policies and practices. Training programs for servers focus on knowledge and skills that enhance their ability to prevent excessive alcohol consumption among patrons and minimize harms from excessive drinking that has already occurred.

Server training may address:

  • Checking IDs
  • Service practices that reduce the likelihood of excessive consumption
  • Identifying and responding to early signs of excessive consumption (e.g., rapid consumption)
  • Identifying intoxicated patrons and refusing service to them
  • Intervening to prevent intoxicated patrons from driving

Summary of Task Force Recommendations and Findings

The Community Preventive Services Task Force finds insufficient evidence to determine the effectiveness of responsible beverage service training programs for reducing excessive alcohol consumption and related harms at the community level.  

Although reviewed studies generally showed positive results for the measured outcomes, these results primarily came from academic research studies that evaluated programs focused on individual establishments and were implemented under favorable conditions (e.g., intensive training programs, short follow-up times). Because of these limitations, further evidence is necessary to assess the public health impact of sustainable, community-wide RBS training programs.

Task Force Finding and Rationale Statement

About the Intervention

The context in which RBS training takes place likely plays an important role in the effectiveness of the intervention. Training programs may:

  • Vary by the type of participation (e.g., state mandated, state-based incentive, voluntary research program)
  • Be targeted at establishment owners, managers, or servers
  • Be offered to groups, or delivered one-on-one
  • Be delivered by professional trainers, managers, or other staff
  • Vary in intensity and content (i.e. program can be 45 minute videotape presentations or 18 hour skill- building sessions)
  • Be offered at on-site or off-site locations

Results from the Systematic Review

Eleven studies published between 1987 and 2009 qualified for the review.

Results show that effects were favorable for the following outcomes:

  • Service policies: RBS training for owners and managers led to positive changes in establishment policies, such as requiring identification checks of underage-looking customers, eliminating drink promotions, providing safe drinking information for customers, denying service to obviously intoxicated customers, conducting regular meetings with the staff, promotions of food and non alcoholic beverages, and arrangement of alternative transportation (4 studies).
  • Server practices: RBS training for servers was associated with positive and consistent evidence of modest changes in observed and self-reported server practices, meaning the frequency of appropriate server practices increased (7 studies).
    • Overall server practices: server training was associated with a moderate increase in appropriate server practices , such as offering food and water, delaying service to visibly intoxicated patrons, commenting on quantity and speed of alcohol consumption, and explaining house policies to customers (4 studies).
    • ID checks for underage-looking patrons: non-significant increases of 5 and 10 percentage points (2 studies)
    • Refusal to serve obviously intoxicated patrons (or trained actors who appeared intoxicated): median increase of 5 percentage points (interquartile interval [IQI]: 3 to 14 percentage points; (4 studies)
    Even after RBS training, however, the frequency of ID checks and service refusal remained low.
  • Alcohol consumption:
    • RBS training generally resulted in a net decrease in the number of alcoholic drinks consumed by the patrons (2 studies, 5 study arms).
    • Overall, a net decrease in mean blood alcohol concentration (BAC) levels was observed among patrons leaving establishments where they were served by trained servers (3 studies, 6 study arms).
  • Percentage of intoxicated patrons leaving an establishment: there was a median decrease of 26.7% (IQI: -58.2% to -9.5%; 5 studies) in the percentage of intoxicated patrons leaving the establishment after being helped by trained servers.
    • However, the effects of RBS training on alcohol consumption and intoxication were small or in the unfavorable direction in establishments where there was a perceived lax regulatory climate, as measured in a survey of bar owners and community members.
  • Alcohol-related harms: three years after a state-mandated RBS training program was introduced in Oregon, fatal single vehicle nighttime crashes decreased by an estimated 23% (1 study).

Although the reviewed studies generally found positive results on these outcomes, two major limitations make it difficult to assess the potential public health impact of RBS training programs:

  1. Most of the evaluated studies were academic research trials conducted in selected establishments, with high-quality, intensive training programs. This raises questions about whether programs implemented under more natural conditions would produce similar results.
  2. The studies reported results for individual establishments, making it difficult to estimate the community-wide impact of the RBS training programs.

These results were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to excessive alcohol use.

This review and Task Force finding replaces the 2001 Task Force recommendation for Intervention Training Programs for Servers of Alcoholic Beverages to Reduce Alcohol-Impaired Driving. Read a summary of findings from the previous review or visit the Motor Vehicle-Related Injury Prevention section of our publications page to access the complete articles.

Supporting Materials

Publication Status

Full peer-reviewed articles of this systematic review will be posted on the Community Guide website when published. Subscribe External Web Site Icon to be notified when we post these publications or other materials. See our library for previous Community Guide publications on this and other topics.




Disclaimer

The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Preventing excessive alcohol consumption: responsible beverage service training. www.thecommunityguide.org/alcohol/beverage_service.html. Last updated: MM/DD/YYYY.

Review completed: October 2010