Sustained Alcohol Service Refusal Rates to Underage Patrons in Nightlife Setting: 25-Year Follow-Up of a Swedish...

Area of Science:

• Public Health
• Substance Abuse Prevention
• Alcohol Policy

Background:

• Stockholm implemented a multicomponent alcohol prevention intervention in 1996.
• The program focused on community mobilization, training, and enforcement to prevent underage and intoxicated alcohol service.

Purpose of the Study:

• To evaluate the long-term impact of the Stockholm alcohol prevention program.
• To assess compliance with the legal minimum age for alcohol service at licensed premises.

Main Methods:

• Six cross-sectional studies were conducted between 1996 and 2022.
• Pseudo-underage mystery shoppers attempted to purchase alcohol at licensed premises.
• The primary outcome measured was the refusal of entry or alcohol service.

Main Results:

• The refusal rate for alcohol service to underage mystery shoppers increased significantly over time.
• Rates rose from 54.8% in 1996 to a peak of 91.3% in 2013, remaining high at 79.6% in 2022.
• All assessed periods from 2001 onwards showed significantly increased odds of refusal compared to baseline.

Conclusions:

• The multicomponent alcohol prevention program has been successfully sustained.
• Consistent high refusal rates indicate effective long-term prevention of underage alcohol sales.
• Collaboration, community mobilization, training, and enforcement are key to program success.