Intervention for reducing off-premise sales of alcohol to underage youth : a systematic review

Introduction The underage drinking problem is becoming a cause for concern in Hong Kong as young people are exposed to an environment with easy access to alcohol. In particular, the off-premise sales of alcohol to underage youth are entirely subject to the industry voluntary code of conduct. Without appropriate legislative changes and enforcement measures, underage youth in Hong Kong could find it relatively easy to obtain the alcoholic beverage in off-premise outlets. Different studies were published to evaluate the effectiveness of interventions for reducing the sale of alcohol to underage youth in off-premise outlets. Aim and Objectives 1. To identify the effectiveness of interventions on restricting off-premise alcohol sales to underage youth 2. To suggest policy and intervention measures to regulate the off-premise alcohol sales to adolescents in Hong Kong based on the findings presented in this review. Methods Literature in this review included articles published in the last 10 years (2003-2013). The literature search was undertaken in the following two pronged method. 1. To identify relevant articles, the following databases were used: PubMed and MEDLINE. The search term: "Alcohol Drinking/legislation and jurisprudence"[MeSH Terms] AND ("2003/01/01"[PDAT]: "2013/12/31"[PDAT]) AND ("adolescent"[MeSH Terms]) were applied. 2. Manual search was conducted according to the bibliographies and reference lists of the articles that were being reviewed. Inclusion and exclusion criteria were applied. Results Numerous articles have been identified regarding interventions to reduce underage access to alcohol in off-premises and shift retailers' behavior in the sale. Such interventions included, but were not limited to responsible beverage sales and service training, intensified compliance check, enhancement of non-compliance penalties, reward and reminder visit and media advocacy. Community based interventions targeting off-premises sale were found to be successful in affecting the behaviour of the retail staff. There was a variation in the magnitude of effects among the studies and this was associated with the intensity of the interventions and the publicity. A decaying effect of interventions was also observed. Conclusion This review identified that implementing a legal purchasing age combined with intensification of compliance check and enhancement of penalties were effective in reducing sales of alcohol to underage youth in off-premise venues. On the basis of the findings, policy suggestions for Hong Kong were presented.published_or_final_versionPublic HealthMasterMaster of Public Healt