What Proportion of On-Trade Alcohol Is Served to Those Who Are Already Potentially Intoxicated? An Analysis of Event-Level Data

OBJECTIVE: Overservice (i.e., venues serving alcohol to intoxicated drinkers) is a major contributor to alcohol-related harm. This article estimates the proportion of all alcohol sold in on-trade premises in Great Britain that is drunk by people likely to already be intoxicated. Secondary analyses explore variations by age and gender and from 2009 to 2017. METHOD: We used cross-sectional data from 1-week drinking diaries collected continuously from 2009 to 2017 via a nationally representative stratified quota sample of 90,968 adults resident in Britain who consumed alcohol in the on-trade across 139,938 occasions. We first identify the amount of pure alcohol consumed in occasions after individuals reach each of three consumption thresholds indicating potential intoxication: at least increasing risk (>48/64 g for women/men), at least high risk (>96/128 g), and very high risk (>144/192 g). We then calculate the proportion of all alcohol consumed in the on-trade each year that is accounted for by consumption beyond these thresholds. RESULTS: In 2017, of all on-trade alcohol consumed, an estimated 43.3% was drunk by those who had already drunk to increasing risk levels, 20.5% by those who had already drunk to high risk levels, and 10.1% by those who had already drunk to very high risk levels. Greater proportions of the alcohol consumed by women and younger people was consumed beyond these levels, but the proportion did not change substantially from 2009 to 2017. CONCLUSIONS: Depending on the consumption threshold used, potentially intoxicated drinkers consume between 10% and 43% of pure alcohol drunk in on-trade venues in Great Britain, suggesting that overservice is commonplace.