- Title
- Increasing compliance with alcohol service laws in a developing country: intervention trial in the Kingdom of Bhutan
- Creator
- Dorji, Gampo; Dejong, William; Gurung, Mongal Singh; Chogyel, Tandin; Wangchuk, Dorji; Kypri, Kypros; Bor, Jacob; Desilva, Mary Bachman; Sabin, Lora; Feeley, Frank Rich; Udon, Pema; Wangchuk, Nima; Wangdi, Ugyen; Choden, Tshering
- Relation
- NHMRC.1041867 http://purl.org/au-research/grants/nhmrc/1041867
- Relation
- Addiction Vol. 111, Issue 3, p. 467-474
- Publisher Link
- http://dx.doi.org/10.1111/add.13202
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2016
- Description
- 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% (differenceadj = 24%; 95% CI = 12-37%) and on Tuesdays: 43-58% (differenceadj = 14%; 95% CI = 1-28%). Differences in refusal to serve alcohol: after 10 p.m. (differenceadj = 15%; 95% CI = -8 to 37%); to underage patrons (differenceadj = -5%; 95% CI = 14 to 4%); and to intoxicated patrons (differenceadj = 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.
- Subject
- alcohol; community intervention; court observation; education; mystery shopper; policy; service
- Identifier
- http://hdl.handle.net/1959.13/1320212
- Identifier
- uon:24094
- Identifier
- ISSN:0965-2140
- Language
- eng
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