Interventions for reducing alcohol supply, alcohol demand and alcohol-related harm

Monograph no. 57

Peter Miller, Tanya Chikritzhs, John Toumbourou

This project synthesises existing evidence and knowledge to improve our understanding of good practice in minimising the range of harms associated with alcohol misuse, especially supply and demand reduction strategies. It builds on the literature by using a Delphi study to answer many of the existing questions for which no research literature yet exists. All interventions that aim to reduce the supply of alcohol discussed in this report have received substantial evidence for their effectiveness. Specifically, reducing alcohol outlet opening hours, increasing minimum legal purchase age, reducing alcohol outlet density and controlling alcohol sales times have each undergone a vast number of evaluations and have been found to be effective in reducing the supply of alcohol and reducing the harms associated with its consumption.

The most promising supply-reduction interventions identified were reducing trading hours for packaged liquor and reductions in the types and size of liquor that can be sold, the public listing of 'violent venues&rsquo' and serving only mid-strength beverages after midnight in late night venues.  Demand reduction strategies appear to be effective; however, there is a lack of research or evaluations in the area. Increasing alcohol excise and taxation has been found to be very cost-effective, as well as being effective in reducing the consumption of alcohol and often results in overall social benefit. However, research for other demand reduction strategies, such as family-based alcohol misuse prevention and developmental prevention interventions is still in its infancy. Although such interventions have received some support for their effectiveness, further research needs to be undertaken.

The most effective harm reduction interventions were the Safer Bars program, targeted policing interventions (including 'consequence policing') and the introduction of plastic glassware. The most promising harm-reduction interventions identified were alcohol management plans in the Northern Territory, the introduction of mandatory security plans for venues, RSA marshals and mandatory high-visibility clothing. The study has identified a large number of interventions for the reduction of alcohol-related harm, but the majority of these have minimal evidence bases. A further concern is that the bulk of interventions have been developed to reduce alcohol-related harm and as a result, there exists few supply and demand reduction strategies. While the most effective solutions have been found to act at the societal level, there is a clear demand for more interventions that focus at community, social, family, or individual levels, even if they are not going to have the same level of impact.