Association between risky alcohol consumption and club alcohol management practices and characteristics
Table
2 displays the results of univariate analyses of the association between club alcohol management practices and characteristics and at-risk alcohol consumption by club members. The eight club alcohol management practices and two club characteristics with a chi square p-value of ≤0.2 were included in the subsequent logistic regression analysis.
Table 2
Univariate association between club alcohol management practices and characteristics and at-risk alcohol consumption by club members
Hold a liquor licence
| | p=0.411 |
Yes | 300 (28.4%) | |
No | 66 (23.8%) | |
Type of liquor licence
| | p=0.572 |
Limited licence-single function | 6 (40.0%) | |
Limited licence- multiple function | 242 (28.2%) | |
Function licence | 12 (17.6%) | |
Written alcohol management policy
| | p=0.843 |
Yes | 140 (26.9%) | |
No | 222 (27.9%) | |
Sponsors who make, distribute or sell alcohol
| | p=0.382 |
Yes | 316 (28.0%) | |
No | 50 (24.2%) | |
Alcohol received from sponsors
| | p=0.248 |
Yes | 67 (34.0%) | |
No | 299 (26.3%) | |
Staff trained in responsible service of alcohol
| 231 (27.8%) | p=0.783 |
All staff trained | 130 (26.5%) | |
Less than all staff trained | | |
Staff consumption of alcohol while on duty
| | p=0.027 |
Never | 183 (23.6%) | |
Rarely/sometimes/usually/always | 183 (32.7%) | |
Availability of low-alcohol options
| | p=0.008 |
Yes | 341 (26.7%) | |
No | 25 (42.4%) | |
Pricing of full strength and low alcohol drinks
| | p=0.758 |
Full strength most expensive | 258 (26.4%) | |
Priced the same or low alcohol most expensive | 69 (28.2%) | |
Availability of food when alcohol served
| | p=0.947 |
Yes | 360 (27.4%) | |
No | 6 (27.3%) | |
Allow intoxicated people to enter club
| | p<0.001 |
Yes | 298 (31.8%) | |
No | 68 (17.1%) | |
Service of alcohol to intoxicated people
| | p<0.001 |
Yes | 321 (31.7%) | |
No | 45 (13.9%) | |
Discounted drinks for a defined period of time
| | p<0.001 |
(‘Happy hour’ promotions)
| | |
Yes | 17 (43.6%) | |
No | 345 (27.0%) | |
Other discounted/cheap drink promotions
| | p=0.374 |
Yes | 17 (34.7%) | |
No | 345 (27.2%) | |
Drinking competitions
| | p=0.003 |
Yes | 98 (40.0%) | |
No | 264 (24.6%) | |
All you can drink promotions
| | p=0.071 |
Yes | 37 (38.1%) | |
No | 325 (26.6%) | |
Alcohol-only awards or prizes
| | p=0.016 |
Yes | 108 (37.5%) | |
No | 254 (24.7%) | |
Vouchers for free alcoholic drinks
| | p=0.216 |
Yes | 51 (34.5%) | |
No | 311 (26.6%) | |
Football code
| | p=0.001 |
Soccer/association football | 55 (17.9%) | |
Rugby League | 103 (25.1%) | |
Australian Rules | 58 (25.8%) | |
Rugby Union | 150 (38.2%) | |
Number of players
| | p=0.008 |
Less than 150 | 181 (34.0%) | |
150 or more | 185 (23.0%) | |
Geographical location
| | p=0.288 |
Major cities | 306 (27.3%) | |
Inner regional | 27 (20.0%) | |
Outer regional | 33 (40.7%) | |
As shown in Table
3, five of the 10 variables entered into the logistic regression model were independently associated with members consuming alcohol at levels linked with immediate harm (p<0.05).
Table 3
Multivariate association between club alcohol management practices and characteristics and at-risk alcohol consumption by club members
Service of alcohol to intoxicated people
| | p=0.0074 |
No | Referent | |
Yes | 2.23 (1.26–3.93) | |
Happy hour promotions
| | p<0.0001 |
No | Referent | |
Yes | 2.84 (1.84–4.38) | |
Alcohol.only awards or prizes
| | p=0.0084 |
No | referent | |
Yes | 1.80 (1.16–2.80) | |
Football code
| | p=0.0004 |
Australian Rules | referent | |
Soccer/association football | 1.25 (0.70–2.24) | |
Rugby League | 1.95 (1.10–3.46) | |
Rugby Union | 2.64 (1.60–4.37) | |
Number of players
| | p=0.0393 |
150 or more | referent | |
Less than 150 | 1.45 (1.02–2.05) | |
Members of clubs where service of alcohol to intoxicated people was observed had significantly greater odds of consuming alcohol at risky levels than members of clubs were this practice was not observed (OR: 2.23). This was also the case for members of clubs that had happy hour promotions (OR: 2.84) or alcohol-only awards/prizes (OR: 1.80).
Members of Rugby Union and Rugby League clubs had significantly greater odds of consuming alcohol at risky levels compared to Australian Rules football club members. Rugby Union club members had significantly greater odds (adjusted odds ratio: 2.1; 95% CI: 1.28-3.47) of consuming alcohol at risky levels compared to soccer/association football club members. Members of clubs with less than 150 players had significantly greater odds of consuming alcohol at risky levels compared to members of larger clubs.
The findings of this study suggest that a number of modifiable alcohol management practices are associated with at-risk alcohol consumption by community sport club members, and that such consumption is more likely to occur in small clubs and in specific football codes. Service of alcohol to intoxicated people, happy hour promotions (where alcohol is provided at a discounted rate for a defined period of time) and alcohol-only awards or prizes were found to be associated with club members being more than twice as likely to consume alcohol to excess. These findings confirm the need and the opportunity for the development and implementation of alcohol harm reduction interventions in these settings [
13].
To our knowledge, this is the most comprehensive study examining the association between the consumption of alcohol by club members and the alcohol management practices of sporting clubs, at either the community or professional level [
7,
23]. The identification of service of alcohol to intoxicated people, happy hour promotions and alcohol-only awards or prizes as predictors of at-risk alcohol consumption is consistent with work conducted in other drinking contexts [
18‐
21], and with professional sports players [
7]. For instance, Dietze and colleagues [
7] found greater alcohol consumption among professional football players who received a drink card entitling them to free drinks, which is analogous to the alcohol-based awards and prizes examined in this study. Also consistent with our findings, Dietze and colleagues found that having formal club rules (or policy) on alcohol consumption was not a predictor of excessive alcohol consumption amongst professional players. Such findings are consistent with evidence from the broader body of scientific literature on licensed premises in general, which suggests that policies alone are insufficient to reduce excessive alcohol consumption and prevent alcohol-related harm [
47].
This study’s finding regarding a lack of association between alcohol-related sponsorship of clubs and at-risk alcohol consumption by club members is in contrast with that of O’Brien and Kypri [
23], who found that players receiving alcohol sponsorship had significantly higher scores on the Alcohol Use Disorders Identification Test than those receiving no sponsorship. A number of factors may account for this contrast. First, the O’Brien and Kypri [
23] study examined an individual’s total alcohol consumption (not only that within the club setting) and covered a number of sports, whereas the present study only investigated the consumption of alcohol within the sporting club setting and focused solely on football clubs. Furthermore, O’Brien and Kypri [
23] examined sponsorship at individual, team and club levels whereas the current study examined sponsorship at the club-level only. Future studies seeking to explore the impact of alcohol-related sports sponsorship may benefit from utilising the more comprehensive approach reported by O’Brien and Kypri [
23].
While previous research has found a positive association between the size of licensed premises and alcohol-related violence (with larger premises associated with greater levels of violence), the relationship between premises size and level of alcohol consumption has received less attention in the literature [
48]. The findings of this study, which suggest that excessive alcohol consumption is greater in smaller clubs, appear to be in contrast to that reported in relation to licensed premises size and alcohol-related violence. As sporting clubs are typically staffed by volunteers [
49] and alcohol consumption is often permitted in large areas surrounding playing fields, including grandstands [
50], the increased risk of at-risk alcohol use within smaller clubs may reflect a lower level of capacity of such clubs to monitor and manage alcohol consumption compared to larger clubs.
By targeting those club practices that have been identified as predictors of at-risk alcohol consumption, community sports clubs have an opportunity to reduce alcohol-related harm involving players and spectators. A number of interventions in non-sporting licensed venues have been found to reduce patron intoxication and prevent alcohol-related harm [
1,
18‐
21] and the potential exists for such interventions to be similarly effective if appropriately tailored to the sports club setting and focussed on the predictors identified in this study. For instance, such interventions should prohibit happy hour promotions and alcohol-only awards and prizes and include strategies to assist staff or volunteers to identify intoxicated patrons, refuse them service of alcohol and ask them to leave the club (actions that are consistent with current state liquor laws [
34]). However, as with non-sporting licensed premises, it is unlikely that these interventions would be effective without adequate monitoring and enforcement [
1,
18,
21,
34,
47,
51]. Given the cost of enforcement, a lower cost strategy for increasing the uptake of harm reduction strategies by clubs is through accreditation with a recognised authority, as has been described by Duff and Munro [
49]. Findings from past, non-randomised studies suggest that such an intervention approach may be acceptable [
52] and have the potential to reduce at-risk alcohol consumption and related harm [
53,
54].
The results of this study need to be considered in the context of the study methodology. First, the study relied on the self-report of club delegates to report on club alcohol management practices. While the validity of such self-reported assessments are not known, self-reported assessment of the health promotion policies and practices of alcohol outlets as well as community organisations such as schools and childcare services is common [
55‐
57], with representatives of such organisations having previously been found to validly and reliably report organisational policies and practices [
58,
59].
The low club consent rate (32%) obtained for this study is likely to be related to clubs being concurrently recruited into a large intervention trial that required an ongoing commitment to data collection and other activities for a four-year period [
24]. Comparison of the characteristics of consenting and non-consenting clubs in terms of football code and location suggested that this risk of bias was limited. Finally, the study involved participation by clubs that served 75% of the population in the most populous state in Australia. The extent to which the findings are generalisable to other states, to other sports codes, and to other countries is unknown and warrants further study.
Further research should be conducted to confirm the findings of this study, particularly in the context of sports other than football. It would also be beneficial if future research investigated the relationship between, and relative importance of, individual and club-based predictors of excessive alcohol consumption and alcohol-related harm.