Do flexible opening hours reduce violence? An assessment of a natural experiment in alcohol policy

• Published in: The Lancet (British edition) 2012, Vol.380, p.S49-S49
• Main Authors: Humphreys, David K, Dr, Eisner, Manuel, PhD
• Format: Article
• Language: English
• Subjects: alcohols; autocorrelation; cleaning; courts; dose response; geographic information systems; Internal Medicine; issues and policy; least squares; local government; monitoring; planning; police; scientists; violence
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(13)60405-5

Abstract Background Throughout history, regulatory approaches to prevent alcohol-related problems have restricted the times and places at which alcohol can be sold. In 2005, the English and Welsh Government took a unique and controversial approach to violence prevention by removing restrictions on opening hours for alcohol outlets. Contrary to traditional restrictive controls, the Licensing Act (2003) proposed to reduce violence by removing restraints on regulated opening hours for licensed premises; thus potentially increasing the physical availability of alcohol. In this study, we treated the removal of trading hour restrictions as a natural experiment in alcohol policy. With a quasi-experimental pattern matching approach, we analysed the Act's effect on violence. Methods The study took place in the City of Manchester, UK (population 464 200, 33 electoral wards) during 2004–08. Data for violent incidents were obtained from Greater Manchester Police Service (GMP). We obtained addresses and trading hours for more than 600 licensed premises from magistrates courts (before intervention records) and local government licensing authorities (after intervention records). All data were cleaned and merged into one database with a geographical information system (GIS). We used three strategies to examine the Act's effect on violence. First, we used an interrupted autoregressive integrated moving average (ARIMA) time-series design to estimate the Act's immediate and delayed effect on violence across the city. Sensitivity analysis was done to examine effects of confounding events (ie, police enforcement campaigns, the smoking ban, etc). Second, we did a process assessment to examine how changes to exposure (ie, alcohol availability and staggered closing hours) were affected by the Act, and whether expected changes were achieved. Third, we did a dose-response analysis to examine whether changes to area-level exposures were related to changes in area-level outcomes (ward-level recorded violence). Ordinary least squares regression models adjusted for changes to ward-level outlet density, and spatial autocorrelation was examined to monitor potential geographical spill-over effects. Findings The results of our analyses identified little evidence that the deregulation of alcohol opening hours affected citywide violence rates. Analysis of total violence showed no evidence of any immediate, temporary, or delayed intervention effects (ω=0·781, 95% CI −0·06 to 0·17). However, a