The Task Force finding is based on evidence from a systematic review of 2 studies (search period through October 2007). The review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to preventing excessive alcohol consumption.
There is no information for this section.
Two studies qualified for the review.
- One study (with a greater intensity of enhanced enforcement) found substantial and statistically significant benefits of the overservice enforcement initiative on all of the outcomes assessed (Michigan).
- Service to individuals pretending to be intoxicated customers: decrease of 28.5% in intervention settings, compared with control settings.
- People arrested for DUI who reported consuming their last drink in a bar or restaurant: decrease of 26.5% in intervention settings, compared with control settings.
- The other study found inconsistent and statistically nonsignificant results for outcomes assessing overservice and alcohol-impaired driving (Washington state).
- Overall, several results pointed in a comparable direction. The estimated effects on the most reliable health outcomes—those related to DUI—showed beneficial effects in both studies.
An economic review of this intervention was not conducted because the Task Force did not have enough information to determine if the intervention works.
Applicability of this intervention across different settings and populations was not assessed because the Task Force did not have enough information to determine if the intervention works.
Each Community Preventive Services Task Force (Task Force) review identifies critical evidence gaps—areas where information is lacking. Evidence gaps can exist whether or not a recommendation is made. In cases when the Task Force finds insufficient evidence to determine whether an intervention strategy works, evidence gaps encourage researchers and program evaluators to conduct more effectiveness studies. When the Task Force recommends an intervention, evidence gaps highlight missing information that would help users determine if the intervention could meet their particular needs. For example, evidence may be needed to determine where the intervention will work, with which populations, how much it will cost to implement, whether it will provide adequate return on investment, or how users should structure or deliver the intervention to ensure effectiveness. Finally, evidence may be missing for outcomes different from those on which the Task Force recommendation is based.
Identified Evidence Gaps
The following outlines evidence gaps for dram shop liability and overservice law enforcement initiatives.
As noted, many of the studies included in this review were conducted prior to the enactment in the late 1990s of various caps on fınancial liability of servers and managers in dram shop cases, in addition to statutes of limitation and increased legal evidence requirements. Further research is needed to assess what impact, if any, these limits on liability have had on the effectiveness of dram shop laws in reducing excessive alcohol consumption and related harms.
Additional studies are needed to assess how effective enhanced enforcement of overservice regulations is in reducing excessive alcohol consumption and related harms. It would be useful to ascertain barriers to effective enforcement. In addition, research is needed to assess the role of the media in publicizing enhanced enforcement and enhancing its effectiveness and the potential role of responsible beverage service training programs in reducing overservice and thus enhancing the effectiveness of enforcement. The latter is important as these multicomponent server intervention programs may prove benefıcial in decreasing excessive alcohol consumption and related harms in on-premises retail alcohol settings. The potential cost savings to owners of on-premises retail alcohol outlets through the promotion of responsible beverage service will be useful in assessing economic benefıts.
The signs of intoxication that a patron exhibits may be diffıcult for servers or law enforcement offıcials to identify. To help servers avoid engaging in illegal service, additional research is needed to improve methods for identifying patrons who are intoxicated, underage, or both. Other methods for avoiding overservice can also be explored, such as counting drinks and spacing out the frequency of drink service through the use of food or nonalcoholic drinks after a predetermined threshold has been achieved.
Although enforcement of existing laws and regulations prohibiting service of alcohol to intoxicated patrons appears to be cost-benefıcial based on the estimated fındings from Washtenaw County, additional studies are needed for a more reliable estimate of the economic value of enforcement.
Finally, additional research is needed to assess the effectiveness of both dram shop liability and enhanced enforcement in achieving these broader societal impacts, but if further research corroborates these fındings, dram shop liability and enhanced enforcement of overservice laws could provide many collateral benefıts.