Community action does little to curb the severe problems arising from risky drinking behaviour, say authors of a new study.
They say their findings, reported today in PLOS Medicine, support the need for legislation to control alcohol.
“The idea communities by themselves can reduce severe harms doesn’t stack up,” says lead author, Professor Anthony Shakeshaft, deputy director of the National Drug and Alcohol Research Centre, in Sydney.
“If alcohol is too cheap, too readily available and too widely advertised, it is kind of unreasonable to expect the community to stop the harms that flow from that.”
It is widely believed that community action is likely to reduce risky drinking behaviour and its associated harms, says Shakeshaft.
“But there’s really been no good evidence whether or not that actually works,” he says.
Shakeshaft says previous findings on the question have come from US-based research on young people, involving a limited range of alcohol-related behaviours.
Community trial
In the first study of its kind, Shakeshaft and colleagues carried out a trial to look at the impact of 13 community-based actions in New South Wales involving 10 communities that implemented the interventions and 10 that did not.
The actions, which were put in place over five years, included education and training at school and work, media messages and advice and other help from GPs, pharmacists, and hospitals.
Using routinely collected data and surveys, the researchers studied the impact of the 13 interventions on risky drinking and its associated harms, including crime, road offences and crashes, and hospital admissions.
The findings suggest community action by itself is not the answer to dealing with alcohol-related problems, says Shakeshaft.
“The community action approach seemed to reduce the lower-level harms,” he says.
“But it had no impact on the more serious alcohol-related harms.”
Shakeshaft says the study found no evidence the community action had an impact on problems such as alcohol-related assault, crashes and hospital admissions.
Low-hanging fruit
Despite low survey responses, he is confident in the findings that community action reduced average alcohol consumption by 20 per cent, and reduced alcohol-related verbal abuse.
But, he says these “lower-level” risks are “low-hanging fruit” that are relatively easier to shift.
“It you want to change the more serious harms then the way to do it is probably through tightening up the legislation.”
He says this claim is supported by international research.
Shakeshaft says the new study only looked at what happened in the communities between 2005 and 2009, and it is possible that community action could have an effect over a longer time frame. He says a future retrospective study could look at whether this is the case.
The new study also raises other interesting questions about the capacity of individual communities to control alcohol-related problems.
While the findings from the new study come from results averaged over all the towns, Shakeshaft says there were significant differences between each community’s ability to control alcohol-related crime.
“Some of them did really well and some of them didn’t and we have no idea why that is,” he says.
“We’re hoping to explore that a little more. What is it about some towns that makes them able to respond well while others don’t?”
