Safer Drinking Scenes - Alcohol, City and Nightlife

Safer Drinking Scenes Alcohol, City and Nightlife

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t night, the public space sometimes becomes a meeting point for young people who, often, consume excessive quantities of alcohol. Local authorities are faced with a series of questions. How to reconcile the different uses of the city at night? How to manage and prevent health, personal and material impacts?

How to organise responses and stakeholders? The aim of this publication is to examine the issues at stake, highlight certain practices and present strategic recommendations that may be of use for local authorities.

This project has received funding from the European Union as part of the ISEC 2009 “Prevention and Fight Against Crime� programme. This publication only reflects the views of the authors, and the European Commission cannot be held responsible for any use which may be made of the information contained therein.

Safer Drinking Scenes Alcohol, City and Nightlife

This publication was produced by the French and European Forums for Urban Security (FFSU and Efus respectively) and is an outcome of the SDS (Safer Drinking Scenes) project. Its main authors are Mark BurtonPage, Project Manager at Efus, and Vanina Hallab, Network and Development Officer of the FFSU. It was undertaken thanks to the kind contribution of the cities involved in the project and with the collaboration of Alberto Dotta and Elsa Fontanille, respectively Project Manager and Communications Manager at Efus, and Nathalie Bourgeois, Editor.

It can be accessed in English and French online at: www.ffsu.org; www.efus.eu. It may be freely used and reproduced for non commercial purposes provided that its source is acknowledged.

Translated by Nathalie Elson Designed by Johann Leclerq Printed by Cloître Imprimeurs, Saint-Thonan (FR) August 2013 ISBN: 2-911687-10-8 EAN: 9782911687105 Legal Deposit: August 2013 Published by French Forum for Urban Security – FFSU European Forum for Urban Security - Efus 10, rue des Montiboeufs 75020 Paris FRANCE Tel: +33 (0)1 40 64 49 00 www.ffsu.org www.efus.eu

Acknowledgements The SDS project and this publication would not have been possible without the dedication of the representatives of the partner cities. We would like to thank elected officials, health and security collaborators from Antwerp, Bordeaux, Brest, Kingston upon Thames, Liege, Nantes, La Rochelle, Reggio Emilia, Rotterdam and Stuttgart for their dedication in making this project a success. We would also like to thank the European Commission and its ISEC “Prevention and Fight against Crime” Programme for the financial support provided for this project. Special thanks go to the experts for their valuable contribution, to the hosts of the various meetings, study visits and final conference as well as all those we had the pleasure of meeting and hearing throughout the project.

Experts : The following experts have largely contributed to the common knowledge that gave its value to this project and is the basis of this publication: Marie-Line Tovar, Responsible for general population surveys, French Observatory on Drugs and Addictions (Observatoire français des drogues et des toxicomanies) - OFDT (France); Dr Laurent Karila, Expert on addiction, Paul Brousse Hospital, Paris (France); Phil Hadfield, Researcher, University of Leeds (United Kingdom); Laetitia Nolet, Belgian Forum for Prevention and Urban Security - FBPSU.

Contents

>>>>>>>>>>>>>> p 11. Foreword Michel Marcus, French Forum for Urban Security p 13. Introduction

Chapter I - The phenomenon p 20. Characteristics, measures and issues Marie-Line Tovar, French Observatory on Drugs and Addictions p 21. p 27. p 29.

1. Ownership of the public space by groups of young people 2. Measures and concepts in Europe 3. Issues of the phenomenon

p 32. Binge drinking: Clinical aspects, consequences and care Dr Laurent Karila, Expert on addiction p 32. p 36. p 38.

1. Clinical aspects 2. Consequences 3. Practical ideas for treatment

Chapter II - Safer public spaces and responsible drinking practices p 42. Safer public spaces: Initiatives by ten European cities Phil Hadfield, University of Leeds p 44. p 46. p 48. p 60. p 63.

1. Density of nightlife activity 2. Coordinated supportive actions 3. Formal regulations and penalties 4. Urban design and service interventions 5. Assessing local norms

p 66. Towards a culture of responsible alcohol consumption in Europe

Chapter III - Observations and recommendations from the SDS project partner cities p 79. Observations p 83. Recommendations

p 88. Conclusions and future prospects Elizabeth Johnston, European Forum for Urban Security p 92. Bibliography

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Foreword >>>>>>>>>>>>>>>>>>>> Michel Marcus Executive Director of the French Forum for Urban Security No-risk human being It’s approaching 19h30, the evening is drawing in, they start appearing at supermarket checkouts. Small groups of young people are queuing impatiently, packs of beer in hand, strong liquors peeking out of armfuls of Coca-Cola bottles. Store managers are ready to open the display cabinets in which are stored branded spirits. The younger ones are exuberant and seem to take over the premises, perhaps to distract from their young age. Parties are flaring up throughout the cities and the countryside. Cigarette smoke is lingering in the streets in the old town, while further along, in discrete corners of parks and gardens, smoking becomes more exotic, and boys and girls are starting to giggle nervously.

These blend and dissolve, evaporating into a laboured, rhythmic, methodical drunkenness. Getting wasted collectively, looking for some sort of performance or asserting a collective refusal of a certain way of life, a future without excitement…

There are many interpretations which highlight our helplessness and difficulty at deciding on the types of actions required. As these lines are being written, the cycling world is celebrating the exploits of a young cyclist overshadowing his predecessors fallen from grace for doping. Internet sales of products designed to enhance physical performance are going through the roof. End of term exams are boosting sales of stimulants increasing attention and memory capacities.

Does the “normal human being” exist? Our sexuality is 11

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no exception to this quest for performance. Alcohol makes us sociable, dynamic, it helps demystify our fears and restraints. However, when massive quantities are consumed together with various substances, it indicates a totally different vision of social life. The group is only the gateway to a process leading to a denial of all individual qualities. Every stereotypical sign of feminity is annihilated when a young woman is scraped off the sidewalk. Similarly, the young junior doctor in a drunken stupor between two cars will challenge our usual conception of life, where knowledge and social responsibilities are closely entwined. These people who seem to be disintegrating will also consume organic food or pop anti-aging vitamins or stimulants. Is this the way the world will move forward? Violence to create and destroy? Self-destruction? Something, someone which needs to be challenged or outdone?

This paradox is the common thread to our public policies. Public order issues coexist with health issues, as does the use of public spaces with individual freedom.

Managing risks arising from excessive consumption requires us to reflect on the meaning of “being human”. The pragmatism required to implement our policies will never erase our constant questioning of the definition of normality. How can we define the “average human being”, a yardstick for measuring both the risk and the acceptable level of transgression?

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Introduction

>>>>>>>>>>>>>>>>>>>> Festive events set the tempo of any city. They bring life to the city and give it added value. Using the streets and public places to party is an integral part of our culture. However, at night, on the edge of these events or during spontaneous gatherings, the public space may become a meeting place for young people who often consume excessive quantities of alcohol. This type of consumption, and especially binge drinking 4, entails a number of risks both in terms of public order and public health.

Local authorities are therefore faced with a series of questions. How can they reconcile the various uses of the city by night, between those who want to party, those who want to work and those who want to sleep?

How can we manage and prevent health, personal and material impacts this phenomenon may have? How do we organise the responses and take all the stakeholders into account? To cope with excessive alcohol consumption, how can public spaces be made safer and how can we promote responsible drinking without sanitising the festivities?

Public peace as well as crime, health and social prevention seem at the heart of responses to these issues, but a number of paradoxes must be included. Our relationship with alcohol remains ambiguous: despite its adverse effects, this drug is culturally accepted and deemed to foster conviviality. Partying has a legitimate function as a social glue, an initiation. But it implies the risk of excessive alcohol consumption by “ordinary� youths who, in this context, adopt risky behaviours.

4 - Binge drinking : excessive alcohol consumption over a short period of time.

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Safer Drinking Scenes - Alcohol, City and Nightlife

Faced with these questions, French cities have decided to work together and to form a working group5 between 2007 and 2009. They decided to continue this work and broaden the scope of their discussion to the rest of Europe by suggesting the “Safer Drinking Scenes” project, led by the French Forum for Urban Security (FFSU) and the European Forum for Urban Security (Efus).

This project received co-funding from the European Union as part of the ISEC “Prevention and Fight against Crime” Programme. Between January 2011 and June 2013, ten cities took part in this project: Antwerp (Belgium), Bordeaux (France), Brest (France), Kingston upon Thames (United Kingdom), Liege (Belgium), Nantes (France), La Rochelle (France), Reggio Emilia (Italy), Rotterdam (Netherlands) and Stuttgart (Germany). An expert panel consisting of Marie-Line Tovar, Responsible for general population surveys at the French Observatory (Observatoire français des drogues et des toxicomanies) - OFDT (France), Dr Laurent Karila, Expert on addiction, Paul Brousse Hospital, Paris (France), Phil Hadfield, Researcher, University of Leeds (United Kingdom), and Laetitia Nolet, Belgian Forum for Prevention and Urban Security – FBPSU have contributed to this project, which was coordinated by Vanina Hallab at FFSU and Mark BurtonPage at Efus.

Objectives The main objective of this project was to share best practices in the prevention of excessive alcohol consumption and in reducing health and safety risks as well as best practices in terms of operational management of nightlife and public spaces. The aim is to improve understanding, methods, tools and local actions by exchanging best practices. The project was also intended to develop strategic recommendations to support and inform other European cities on this topic.

5 - Reports available at www.sds-project.eu

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Through this project, partners have sought to: • Promote a better understanding of the phenomenon by relevant stakeholders in order to raise public awareness (youth, parents and more); • Understand local partnerships to manage this phenomenon and associated risks; • Provide local actors with operational tools to address this issue effectively and efficiently; • Promote dialogue and information sharing between European cities on promising actions or emerging issues; • Establish a common approach to political recommendations.

The many topics addressed (addictive behaviour, crowd control and management of public spaces, health prevention, prevention of nuisances, violence and victimisation, raising awareness and others) as well as the range of different stakeholders (elected representatives and local decision makers, police, medical staff, front-line players ...) indicate the broad nature of the project. With a comprehensive and integrated approach, the issue is addressed from three different points: • Health risks arising from excessive alcohol consumption; • Risk of a rise in violent crime, nuisances and more generally deviant behaviour while considering consumers as potential “offenders”; • Increased risk of victimisation of vulnerable consumers who may become potential victims.

Object of the study The object of this study had to be defined precisely before sharing promising practices in the best possible way. Local authorities decided, within this project, that organised events such as student parties, festivals and local events should be considered separately to those qualified as “spontaneous”, such as gatherings outside 15

Safer Drinking Scenes - Alcohol, City and Nightlife

nightclubs or in public squares at weekends. It was established that the targeted population, whether victim or offender, would include young people between 13 and 25 years of age and more specifically students.

Another specific angle chosen was to work on the excessive, periodic and problematic alcohol consumption (hyper-alcoholisation) among these young people. A final distinction was made according to where these incidents took place; indeed, the project concentrated on highly populated urban areas, and more specifically on city centres where nightlife is vibrant. The link between these different patterns of consumption, the targeted population and the different locations is the public space, hence the title of the project being: Safer Drinking Scenes.

Activities and methods Throughout the project, partners’ activities were structured around two axes.

• It first involved gathering examples of good practices, i.e. promising actions, research, positive and creative experiences in this field. Approximately 30 different practices have been collected and are available as summary sheets6.

• Following this first stage, study visits were organised in each partner city to explain local actions and encourage discussions among various local actors (cities, police, mediation services, associations, nightclubs, medical and emergency services). Eight cities were visited between May 2011 and May 2012.

The idea was to gather different experiences and allow cities to share their views and explain the way an innovative and appropriate response was implemented according to a given situation. The aim was also to develop recommendations to address the cities’ 6 - www.sds-project.eu

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common concerns: How can the risks of excessive consumption for the younger population be reduced while ensuring a necessary balance between public health and public security? The project has highlighted certain specificities and creative modes of action which could be a source of inspiration and be transferred to other European cities.

The different experiences, projects and actions that have been included into the project matrix are based on a public peace strategy with various inputs including education, mediation, prevention, risk reduction and regulation. As an in-depth understanding of the phenomenon is needed, the cities’ main concern is to provide a fair response. The aim of these cities is not to ban alcohol consumption or partying, but to prevent excesses, inform the public about the risks, reduce the latter and manage nightlife and public spaces efficiently.

This project provides concrete answers that can be used to develop a coherent and interdisciplinary risk management policy based on current practices in French and other European cities. However, the issue of excessive alcohol consumption goes beyond the management of public spaces. This project challenges other policies: Youth (well-being, identity, becoming self-sufficient), education (parenting support) and nightlife economy. Following this first stage, the project could be expanded to provide further answers for the general public (parents, young people).

Alcohol, city and nightlife The objectives of this publication are to present the results of the project and the observations of the experts, to highlight some practices and to offer strategic recommendations that can be of use for others. Chapter I presents the phenomenon as such, the types of location and public spaces it examined, the types of event, population and consumption, the issues raised as well 17

Safer Drinking Scenes - Alcohol, City and Nightlife

as the clinical aspects, risk factors and consequences of binge drinking. Chapter II addresses the issues of how to reinforce security in the public space and how to promote responsible alcohol consumption while taking into account the experience of the cities that were partner in the project. Finally, observations and recommendations by partner cities are explained in chapter III.

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Chapter I >>>>>>>>>>>>>>>>>>>>

The phenomenon >>>>>>>>>>>>>>>>>>>>

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Safer Drinking Scenes - Alcohol, City and Nightlife

Characteristics, measures and issues >>>>>>>>>>>>>> Marie-Line Tovar Responsible for general population surveys, French Observatory on Drugs and Addictions Massive and repeated alcohol consumption by young people is a major public health problem in all European countries as well as in the United States. The amounts recommended by the World Health Organization for a one-off safe consumption (i.e. a maximum of four standard glasses) are widely exceeded. Frequently referred to as binge drinking, this Anglo-Saxon concept is not clearly defined and divides experts, particularly regarding the deliberate intent to achieve drunkenness.

The urban public space includes all crossing points and gathering places for the use of everyone. It may be a square or a plaza, a street, a boulevard or an avenue, but also a garden, a small or large urban park, a riverside footpath, a car park or the surroundings of an industrial area, a shopping mall or a housing block. As part of the Safer Drinking Scenes project, the issue of excessive alcohol consumption among young people aged 13 to 25 in the public space also takes into account potential alcohol consumption in closed and private spaces (such as bars, nightclubs or terraces) and its impact on the public space.

These different uses may generate conflicts especially if risk taking and consumption of alcohol and other psychoactive substances are rife. One of the challenges faced by cities is to find the best balance between the different uses made of the public space, so that it may be enjoyed by everyone without social conflicts.

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1. Ownership of the public space by groups of young people

>>>>>>>>>>>>>>

This phenomenon has been identified through the SDS project: Places and population involved, practical arrangements during gatherings and issues associated with these practices. Each city visited has its own identity but also common traits with other cities. Most of them are port cities and university cities welcoming young people from all backgrounds. Many also have a large immigrant population. All offer a wide selection of festive events and an active nightlife.

The phenomenon therefore involves young people in open public spaces. This results in the use of psychoactive substances and excessive alcohol consumption in different areas in all the partner cities.

A wide range of open spaces These meeting points are mainly located in city centres, which are open spaces favoured by the younger population, and which offer a wide range of venues selling alcohol. The most popular areas are squares (Antwerp, Brest, Liege, La Rochelle, Nantes and others), ports (Brest, etc.), nearby railway stations (Liege, Reggio Emilia...) and in the vicinity of theatres, bars and nightclubs. Their size varies: from small areas, such as a single street, to entire neighbourhoods where venues are open day and night (near the Garonne riverside in Bordeaux with bars and nightclubs, the CarrĂŠ district in Liege with its many bars, the Saint Nicolas district in La Rochelle, and venues along the Loire in Nantes).

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Safer Drinking Scenes - Alcohol, City and Nightlife

Massive consumption in enclosed spaces Alcohol consumption in private enclosed spaces (such as bars and clubs) moves to the public space later in the evening, where many groups of intoxicated young people will start gathering. In some cities such as Kingston upon Thames, nightclubs are open all night.

In Stuttgart, a number of nightclubs and bars are located in a large wooded area. This is also the case in Bordeaux with venues along the Garonne or in Nantes with its large nightclub. At closing time, hundreds of young people invade the public space (neighbourhoods, streets or squares), a phenomenon that has led some cities to introduce modifications in the urban layout. For example, in Kingston upon Thames, nocturnal gatherings in the city centre can reach up to 16,000 people, and as a consequence the city enlarged the sidewalks.

Organised or spontaneous events and mobility within these spaces Occasionally, festive events organised in cities are also an opportunity for group gatherings and excessive consumption: festivals (in Rotterdam, in France the yearly music festival of the “fête de la musique”, in Stuttgart the “Volksfest” beer festival), free summer parties where hundreds of youngsters party in the streets until six in the morning.

Other more recent events such as the “giant aperitifs” organised via Facebook or mobile phones have resulted in large gatherings: almost 8,000 people in the squares of Brest, hundreds at the Miroir d’Eau and on the banks of the Garonne in Bordeaux or on the beach in Rotterdam.

Other phenomena have been observed such as youth mobility in space and time and night-time itineraries.

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This mobility is also linked to the time it takes for new residents in these cities to take ownership of different areas. In one of the partner cities, first year students meet every year in September in a very central location.

By November, these groups have moved to other local bars. Later in the evening, young people gather on a square in the city centre or meet in neighbourhoods where bars and clubs are still open.

Consumption at home prior to going out is often observed. This behaviour is similar to the pre-loading by young people in the United Kingdom, whereby they consume alcohol at home before going out to join their friends in the pub, in order to get drunk more rapidly.

In Bordeaux, some young people between the ages of 16 to 25 start drinking alcohol at home (e.g. in their student rooms), then meet in public places or around nightclubs. This is the case of La Rochelle: The party starts at around 11PM at home, then they go to bars which close at 2PM and finish their evening in the car parks of nightclubs. During the Beer festival in Stuttgart, a large amount of alcohol is consumed before entering the festival.

Description of the young people involved These gatherings involve socially integrated young people (students, pupils, young workers) who meet either regularly, generally at weekends, or occasionally (for giant aperitif, end of exam partying) but also a marginalised population (homeless young people, migrants and others).

Students regularly organise parties at weekends to which other people (especially young workers) take part. Most often, these events take place on Thursday evenings, Friday evening being considered as part of the weekend which is often spent with family.

However, partying also takes place on Friday, Saturday 23

Safer Drinking Scenes - Alcohol, City and Nightlife

or even Sunday evenings. Periods of alcohol consumption are more specific for secondary school pupils, often linked to certain periods in time, such as end of exams or beginning of the summer holiday.

The youngest are also concerned: in Liege, young people under the age of 16 may not consume alcoholic beverages in bars, but may purchase alcohol which they drink after school in the Carré. In Stuttgart, they can start drinking at the Volksfest, the beer festival, (if they are accompanied by their parents) from the age of 16 and in La Rochelle, young people aged 14 to 16 gather in the Saint Nicolas quarter with drinks purchased elsewhere.

“Respect 16” LIÈGE

Issue The ban on selling alcohol to minors under the age of 16 was not complied with in the licensed venues in the Carré (Liege’s nightlife district).

Furthermore, the sale of alcohol under 22° was authorised regardless of age in local retail shops. This resulted in easy access to alcohol, which became an issue.

Objectives To reduce the alcohol on offer to minors in the Carré. To raise awareness among shopkeepers on their responsibility in youth alcohol consumption and sanction if needed. To protect young people as potential victims.

Actions A prevention plan was developed to implement the methodology. An interview guide was created as a support for inspectors in the 24

neighbourhood during the awareness campaign and to collect data on knowledge and behaviours of the professionals interviewed. A questionnaire aimed at young people under 16 who “used” the area of the Carré was developed and distributed. The data collected (interview guide, youth questionnaire and action plans) were included into the local study on supply and consumption of alcohol by young people, carried out by the Monitoring Centre for Drugs in Liege (Observatoire liégeois des drogues).

Local police officers were deployed in the area to raise awareness among shopkeepers on their responsibility in youth alcohol consumption. A law enforcement action plan was then developed. The Confederation of Belgian Brewers contributed to producing various tools for this project (posters and stickers). Two press conferences were organised to inform the population of Liege on the project and its results.

The population who consumes alcohol in open public spaces also includes marginalised people such as migrants or homeless youngsters in Rotterdam, wandering young people, homeless people and travellers in Bordeaux, and young migrants who gather around the railway station in Reggio Emilia.

Reasons for using the public space A qualitative survey carried out by the French Observatory on Drugs and Addictions (Observatoire français des drogues et des toxicomanies - OFDT 4) on the 4 - Required by the DASES (Département de l’action sociale, de l’enfance et de la santé) and carried out by the OFDT TREND system (Recent trends and new drugs) in 2011. www.ofdt.fr

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Safer Drinking Scenes - Alcohol, City and Nightlife

consumption of alcohol by young people in public open spaces in Paris provided highlights on the reasons for going out and gathering in the areas observed.

Among the reasons given, two stand out: “need to go out with friends at night” and “convenience offered by these open spaces”. As noted in La Rochelle, “young people feel safe partying in city centres”. These meeting spaces are viewed as offering a different, friendly atmosphere. In this context, alcohol stimulates, frees all inhibitions and makes socialising easier. It becomes a tool for partying without being the only element contributing to conviviality. One of the reasons for using open spaces is to break with the usual going out scenario: The search for a pleasing space (aesthetics and appeal of the sites) and outdoor activities (music, football, dance, singing and others...).

Other arguments mentioned include the absence of control and constraints (sense of freedom, no professional or parental control), the fact of being together (partying without space limit) and cheaper alcohol (compared to the price of alcohol in bars).

These gatherings may not be related to the binge drinking phenomenon. Motivations for going out are primarily to party where alcohol makes socialising easier.

Several people interviewed in different groups do not drink alcohol.

These outdoor parties have always existed. What’s new is their frequency. These locations are rallying points for small groups of young people, independent from one another, but who eventually all know one another.

Another example is Spain, where young people gather to drink and have fun in the public space, “in a car park or any other suitable place”. Originally, these botellones (literally “big bottle”) were gatherings of young people who were looking for a good night out away from the 26

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commercial system of bars and nightclubs. Now, these youth gatherings have moved towards the AngloSaxon behaviour where the ultimate goal is drunkenness.

2. Measures and concepts in Europe

>>>>>>>>>>>>>>> Definitions

The massive consumption of alcohol in a very short time, often referred to as binge drinking, is identified at European level and measured in surveys among the general population as heavy episodic drinking (HED).

It is generally described as the consumption of large quantities of alcohol over a short period of time, either as a one-off or repeatedly, with the aim of achieving rapid drunkenness.

In its recommendations, the World Health Organization (WHO) has established a limit of four standard glasses for a one-off safe consumption: HED starts when this limit is exceeded.

There is no international consensus on the number of “standard drinks” consumed during a binge drinking session. In the United States, according to the National Institute for Alcohol Abuse or Alcoholism (NIAAA), the definition of binge drinking is based on the concentration of alcohol in blood (from 0.08 g). For an adult male, this equates to the consumption of five or more drinks during one single sitting (over a period of two hours) and four or more drinks for an adult female.

In Britain, the term “binge drinking” is defined in units, i.e. twice the daily limit set by the WHO, mea27

Safer Drinking Scenes - Alcohol, City and Nightlife

ning at least eight standard alcohol units for men and at least six for a woman in one single day. Due to wide variations from one individual to another (weight, alcohol tolerance...) and the speed at which the alcohol is consumed, there is no simple and obvious link between the number of units consumed, the concentration of alcohol in blood and the effects felt by the user. For this reason, it was proposed to include the subjective “level of intoxication� into the questionnaire. Furthermore, achieving drunkenness may be one of the aims of binge drinking, but this may not be the case for everyone.

Thus, measuring the number of binge drinkers in the European population must take into account these various consumer behaviours and the different calculation methods.

Alcohol consumption and measurements of HED among young Europeans The most recent data come from the latest ESPAD survey (European school survey project on alcohol and other drugs) carried out between April and June 2011 in 36 European5 countries with young people aged 15 to 16. The survey compares the different levels of use of psychoactive substances by school teenagers in most European countries. The survey is carried out according to a standardised methodology identical in all participating countries and based on a common selfadministered questionnaire.

With regard to alcohol consumption in 2011, 57% of young Europeans said they had consumed alcohol in the last 30 days. The highest rates, reaching 70%, were found in Cyprus, the Czech Republic, Denmark and Germany. In contrast, Ireland reported a very low 5 - 2011 ESPAD results: http://www.espad.org/

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consumption (17%) and Scandinavian countries, except for Denmark, a level below 50%. On average, boys were more affected than girls. This difference is significant in 18 countries.

To measure alcohol consumption aiming for drunkenness, youngsters were asked a more standardised and less subjective question regarding the number of times they had consumed more than five alcoholic drinks in one sitting over the last thirty days. This “Heavy Episodic Drinking” concept has replaced the term “Binge Drinking” used in previous surveys in order to dispel any misunderstanding.

On average, 39% of European students reported having had a drinking session where five or more drinks were consumed (in a short period of time) over the last 30 days. 14% reported having had at least three such sessions over the same period. The prevalence of HED was the highest in Denmark and Malta, where 56% of 15 to 16 year olds reported at least one episode over the last thirty days. Croatia, the Czech Republic, Slovenia, Great Britain and Slovakia reported rates between 50% and 54%, while Iceland had the lowest rate at 15%.

The ESPAD survey reveals a picture of European young people being quite heavy alcohol consumers, but above all, consumers who have widely adopted HED practices.

3. Issues of the phenomenon

>>>>>>>>>>>>>>> The phenomenon of mass consumption of alcohol in public spaces is not without danger for consumers and is a source of social tension for nearby residents. Excessive consumption of alcohol may result in serious 29

Safer Drinking Scenes - Alcohol, City and Nightlife

accidents, ethylic comas, violence and even deaths.

Security, either for consumers or for residents, is a major issue for cities. But while the youngsters declared they felt “safe partying in the city centre”, residents were developing a strong feeling of insecurity.

Risks to consumers in unsecured areas Some unsecured locations, such as near rivers or the sea (along the river Loire in Nantes, on the beach in Rotterdam, etc.), as well as those located near railways, motorways or cliffs (Brest) can have dramatic consequences: in recent years, one individual died on the beach in Rotterdam, five people drowned in Bordeaux and two in Nantes. Fatal accidents have occurred in Nantes during large festive public gatherings such as “giant aperitifs” which are often unofficial and unsecured.

Active and passive violence related to excessive alcohol consumption During the ESCAPAD survey carried out in 2008 by the OFDT among 17 year-olds, 21% of 17 to 18 year-olds reported having hit/assaulted others as a result of alcohol consumption and nearly a quarter of reported fights (23.8%) were due to intoxicated individuals.

Over and above these figures, the study of alcohol as a predictor of violence indicates that, regardless of the amount or method of consumption, there is a significant link between violence (active and passive) and alcohol consumption (either through regular use, drunkenness or heavy episodic drinking).

The proportion of active violence in relation to the amount of alcohol consumed varies according to the way this alcohol is consumed. For all physical assaults reported by 17 year-olds over the past year, 71.7% of 30

perpetrators reported a one-off massive consumption of alcohol over the past month (against 51.5% of all respondents). In general, people who have the highest alcohol consumption were overrepresented among perpetrators of physical assaults.

The situation is similar when considering all forms of violence (assault, threats, taunts or theft ). Whatever the type of violence, individuals who consume high quantities of alcohol are more likely to engage in violent acts. Much of the recorded violence (passive or active) can be traced back to a small group, in particular, problem consumers who represent a significant proportion of those involved in violence.

Social tensions The presence of intoxicated young people in public areas creates a strong feeling of insecurity among local residents. Apart from noise disturbances, often close to bars or terraces, residents are worried about violence (fights, assaults...) and “open drug and alcohol scenes�. These locals no longer dare to go in certain areas and local authorities are often asked to find solutions to ensure public order and peace for residents.

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Safer Drinking Scenes - Alcohol, City and Nightlife

Binge drinking: Clinical aspects, consequences and care

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Dr Laurent Karila Expert on addiction, Paul Brousse Hospital, Paris (France)

1. Clinical aspectsÂ

>>>>>>>>>>>>>>> General information6

Binge drinking is a social phenomenon that is now widespread in some European countries, such as Finland and Denmark, countries from Eastern Europe and the United States, and which has been increasing over the past 20 years. It has received broad media coverage as a public health issue that particularly affects teenagers and young adults. Health professionals must get involved, especially in information, education and prevention campaigns.

Binge drinking, which usually takes place in the evening or at weekends, is the consumption of large quantities of alcohol in a short amount of time, i.e. generally less than two hours. The amount consumed during a binge drinking session varies according to sex, with at least four standard glasses for women and five for men (see the above detailed definition). This type of alcohol consumption results in a alcohol concentration in blood greater than 0,8 g/l. Whatever the amount 6 - Karila et al. (2009), “Le binge drinking chez les jeunes�.

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needed, the only aim of these teenagers and young adults is massive intoxication (“getting wasted”).They generally don’t drink on a daily basis, but consume large quantities during a binge drinking session.

Binge drinking generally takes place during private or public festivities. Recently, binge drinking sessions occurred during giant “aperitifs” organised in the streets via social networking media such as Facebook. The same applies for Skins parties (alcohol and other drugs, sex, short films made with smartphones...), integration parties or fresher initiation parties for various schools or universities. Hazing is now banned but was popular among students. It already existed in ancient Greece and references can be found since the Middle Ages in Europe. It is also present in Northern Africa.

Alcohol abuse was already part of these events. During the 16th century, alcohol consumption was mandatory for graduation. Compulsive alcohol abuse has been reported as early as the beginning of the 19th century as well as many accidents related to alcohol consumption.

Alcohol in the “grandes écoles” (prestigious French universities) is particularly important and its consumption is an integral part of building social relationships among students. Because of intense academic competition and pressure from parents and teachers, these students consider their university years as an ordeal during which their one and only goal is to successfully pass their final exams. Alcohol may be instrumental in bringing people together and reaffirming community values.

Alcohol industry The drinks industry also plays a major role in the binge drinking phenomenon. Among others, it has developed alcoholic products aimed at the younger generation, such as premixes, ready to drink and alcopops.

These are low-alcohol beverages, mixtures of fruit and 33

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alcohol (white spirits, wine), beer and spirits (e.g., vodka and beer) or white spirits (vodka, rum ...). Their names are exotic (Desperado, Tequila, Soho, Malibu ...) or trendy (Two Dogs, Seagram’s Coolers or Wild Turkey Cola). They also include champagne Pop (small bottles to be drunk with a straw). Their taste (sweet, light and fruity) and low alcohol content are specifically designed to avoid immediate drunkenness. Packaging is extremely important with sophisticated, trendy or even “collector” bottles or cans. The young consumer is attracted by the fun aspect of the drinks’ packaging and names: Boomerang, Delirium Tremens (acute form of alcohol withdrawal syndrome in withdrawal syndrome in alcohol-dependent subjects), Bacardi Breezer, Masaï or Oko. The relatively cheap price of these drinks also explains their increased consumption7.

Nowadays, Internet plays a vital role in marketing operations with the use of advertisements, promotional films, newsletters, social networks (Facebook, Twitter ...).

It is also used to create target groups, organise competitions and send discount coupons for online or in-store purchasing. One of today’s common practices is to compile accurate consumer lists. These consumers are then informed by email or text on new products or receive priority invitations to sample these new products. Alcohol brands may also informally sponsor major events where the youth is the main target. They also take a specific interest in female consumers8.

Risk factors The risk factors of binge drinking are a combination of individual and environmental factors as well as an encounter with alcohol9.

7 - Karila (2010), “Alcoolisme - Idées Reçues ”.

8 - Ibid.

9 - Ibid

34

Nowadays, the binge drinkers can be as young as 12 or 13 years old. The fact that binge drinking is affecting increasingly younger teenagers is extremely worrying as this may become an addictive behaviour for vulnerable individuals. The one-off, no limit alcohol consumption is at its maximum for individuals between 15 and 20 years old10. It becomes more intense in a festive environment after the young people have left secondary education11.

Half the binge drinkers are in the 18 to 25 age group12.

Approximately 33% of men and 15% of women are still binge drinkers by the age of 40. Among teenagers who have their own money, there is a high frequency of binge drinking and public consumption. Alcohol is most often obtained outside of a parental or family context (peers, older brothers or sisters, unrelated adults). Peer influence in this type of behaviour is a key component as it is perceived as the norm13.

Exclusion from school and unemployment among young people is an important factor in binge drinking. The same is true when moving to university, with the changes it brings to these youngsters’ life (belonging to a group or a fellowship, use of on-site accommodation, hall of residence). Parental tolerance with regard to alcohol consumption, children’s first episodes of drunkenness, consumption habits within the family, educational shortcomings and absence of family ties are environmental risk factors for binge drinking14. It is vital to dwell upon the environment in which these young people live, including the attitude of permissive parents which is often harmful.

10 - Kuntsche et al. (2004), “Characteristics of binge drinkers in Europe”.

11 - Plant, et al. (2009), “The social consequences of binge drinking: a comparison of young adults in six European countries”.

12 - Ibid.

13 - Bellis et al. (2007), “Sexual uses of alcohol and drugs and the associated health risks: a cross sectional study of young people in nine European cities”.

14 - Zarzar et al. (2012), “Association between binge drinking, type of friends and gender: a cross-sectional study among Brazilian adolescents”.

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Safer Drinking Scenes - Alcohol, City and Nightlife

Clinical characteristics It seems that extroverts more often revert to this behaviour of alcohol consumption. These users seek excitement, new experiences, thrills, fun or loss of inhibitions but alcohol is never used as an anxiolytic, a sedative or an antidepressant for self-medication. This is clearly different to young alcohol-dependent individuals previously encountered, in whom psychiatric comorbid tendencies such as depression, suicide attempts, anxiety disorders or antisocial personality disorder were found15.

Consumption with other products Alcohol is often consumed with other psychoactive substances, which represents a high risk of secondary addictive behaviour. Tobacco remains the most frequently used substance, especially by men16. Cannabis is by far the most widely used illicit substance at parties17. However, it only involves a small number of binge drinkers who consume alone, away from the parties. The consumption of cocaine and ecstasy is occasional but must be taken into account18.

2. Consequences

>>>>>>>>>>>>>>>

Binge drinking results in neurotoxic damage19. Adolescence is a period of brain maturation as well as phy15 - Karila et al. (2009), op. cit.

16 - Beck et al. (2011), “Increasing trends in screening for addictive behaviors among general practitioners in France”.

17 - Ibid.

18 - Petit et al. (2009), op. cit.

19 - Silveri (2012), “Adolescent brain development and underage drinking in the United States: identifying risks of alcohol use in college populations”.

36

sical and psychological maturation. When alcohol is repeatedly consumed in large quantities, over short periods of time, it could be at the root of gene alteration for certain neurotransmitters, reduced volumes of the ventral striatum, the olfactory bulbs and a reduction in the density of cholinergic neurons. This would result in a learning deficit in adulthood20.

Binge drinking is associated with impaired neurocognitive performances and alterations to the brain structures (grey and white matter) as well as the functional brain activation, which are not observed in non-drinkers. Such anomalies are also found in teenagers with a family history of alcohol use disorders. Neuromaturation differences in these populations are an important risk factor for developing alcohol or drug related addictive disorders21. Chronic binge drinking is also a predictive factor of alcohol addiction later in adulthood.

However, all binge drinkers will not develop alcohol addiction. During their transition to working life, when starting a family, most of these young people will stop binge drinking and become responsible adults22.

There are physical consequences to binge drinking, such as a modification of the brain electrical activity for the most severe binge drinkers (consuming more than 10 drinks per binge drinking session). This includes seizures23 but also dizziness, discomfort, trauma and 20 - McQueeny et al. (2010), “A preliminary study of functional magnetic resonance imaging response during verbal encoding among adolescent binge drinkers”; Schweinsburg et al. (2011), “Neural correlates of verbal learning in adolescent alcohol and marijuana users” ; Squeglia et al. (2011), “Adolescent binge drinking linked to abnormal spatial working memory brain activation: differential gender effects” ; Squeglia et al. (2012), “Binge drinking differentially affects adolescent male and female brain morphometry”.

21 - Bava and Tapert (2010), “Adolescent brain development and the risk of alcohol and other drug problems”.

22 - Karila et al. (2009), op. cit.

23 - Courtney and Polich (2010), “Binge drinking effects on EEG in young adult humans”.

37

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coma24. Binge drinking is also a risk factor for atherosclerosis25, which can aggravate the first attack of acute pancreatitis26 and may cause a heart attack27. In psychiatric terms, there is no link between binge drinking and depression. However, concomitant mood disorders must be investigated. Various studies have indicated a link between frequent binge drinking, generalised anxiety disorder28 and eating disorders (known as drunkorexia 29). At a societal level, heavy alcohol consumption may be the cause of traffic accidents, sexual assaults, unwanted pregnancies 30, violence, school dropout and sometimes death of some students.

3. Practical ideas for treatment

>>>>>>>>>>>>>>>

From the analysis of medical literature, the main points to be included in any sort of treatment are as follows: • Need for early detection31 • During a consultation, always ask the young person information on his/her alcohol and other drug consumption • Assess the situation from complications (traffic accident, sexual behaviour...)

24 - Karila et al. (2009), op. cit.

25 - Pletcher et al. (2005), “Alcohol consumption, binge drinking, and early coronary calcification: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Study”.

26 - Deng et al. (2010), “Binge drinking aggravates the outcomes of first-attack severe acute pancreatitis”.

27 - Pletcher et al. (2005), op. cit.

28 - Cranford et al. (2009), “Substance use behaviors, mental health problems, and use of mental health services in a probability sample of college students”.

29 - Barry and Piazza-Gardner (2012), “Drunkorexia: understanding the co-occurrence of alcohol consumption and eating/exercise weight management behaviors”.

30 - Bellis et al. (2008), “Sexual uses of alcohol and drugs and the associated health risks: a cross sectional study of young people in nine European cities”.

31 - See practices in Kingston upon Thames presented below.

38

• Inform on potential risks • Develop periodic prevention campaigns using the Internet, 2.0 techniques32 and social networks.

Care must include a physician (at the frontline), prevention specialists, health policy actors, the school team and the family. In addition, there are pharmacological approaches to binge drinking33.

In terms of psychotherapy, brief interventions using motivational approaches have known to be effective in reducing alcohol consumption34. A 10-day telephone follow-up after an intervention has shown to reinforce what has been taught35. Programmes including brief cognitive behavioural therapy are other effective treatment options36.

“Protocol for early intervention” KINGSTON UPON THAMES

Issue According to data published in 2007 by the Northwest Observatory of Public Health, in the London area, Kingston upon Thames reported the third largest number of hospital admissions of young people under the age of 18 for

32 - Macmaster S. et al. (2012), “The use of computer technology to reduce and prevent college drinking”.

33 - Karila et al. (2011), op. cit.

34 - Chermack et al. (2012), “Brief motivational interviewing intervention for peer violence and alcohol use in teens: one-year follow-up”.

35 - Bernstein et al. (2010), “A brief motivational interview in a pediatric emergency department, plus 10-day telephone follow-up, increases attempts to quit drinking among youths and young adults who screen positive for problematic drinking”.

36 - McCarthy and O’Sullivan (2010), “Efficacy of a brief cognitive behavioral therapy program to reduce excessive drinking behavior among new recruits entering the Irish Navy: a pilot evaluation”.

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problems related to alcohol only. In addition, according to a year-long study on emergency calls to London ambulance services for alcohol-related incidents, 30% of them involved young people between the ages of 18 and 25.

Objectives Two objectives were identified as priorities: To reduce risky behaviours among young people with regard to abuse of certain substances and to implement early identification and early intervention.

Actions This three-year project is supported by an annual action plan and follows a working protocol agreed between the Kingston upon Thames Hospital A&E and the Youth Service for Substance Abuse managed by local authorities. When a youngster is brought to A&E with injuries related to alcohol or drug use, a member of the medical team, with the authorisation of the youth and/or a parent if that person is a minor, faxes a standard form containing details of the incident to the Youth Service. The Youth Service will then carry out a telephone follow-up to inform and advise the youth, while conducting a preliminary investigation to determine the circumstances of the incident and if there are other needs and/or if there is a history of risky behaviours. If the situation is deemed of concern, the youth is invited to meet a member of the team for a more detailed assessment of his/her needs. This assessment is then used to determine whether additional measures are necessary (specialist treatment or brief intervention by the youth protection services).

40

Chapter II >>>>>>>>>>>>>>>>>>>>

Safer public spaces and responsible drinking practices >>>>>>>>>>>>>>>>>>>>

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Safer public spaces: Initiatives by ten European cities

>>>>>>>>>>>>>> Phil Hadfield Researcher, University of Leeds (UK) European societies are witnessing increasingly common experiences in relation to the direction of development within their night-time economies, the drinking practices of young people, and shared concerns of balancing quality of life indicators of urban vibrancy / residential tranquillity and economic prosperity against those of community safety, public health and security management. Furthermore, the experiences of the ten European cities involved in the SDS project have echoes of those found elsewhere in the world37. Whilst the “alcohol question” relates to aspects of national and regional cultural histories, as well as socio-economic factors - in many ways, it is at the local and particular level that better understandings can be gained and effective responses developed.

The opportunities to look in detail at issues and interventions in individual cities and European contexts have been rewarding aspects of the SDS research process.

The ten city visits and surrounding discussions were written up by the SDS coordinators as case study reports – based upon documentary sources and minutes of local project meetings – exploring how health, policing, regulatory and welfare services were responding to local problems in each city.

37 - Hadfield (2009), “Nightlife and Crime: Social Order and Governance in International Perspective”.

42

Few, if any, of the local initiatives reported to the SDS team had been tested to the scientific gold standard of the Randomised Controlled Trial (RCT). Evaluation at city level was typically more rudimentary, looking at statistical correlations, simple before-and-after comparisons and practitioner feedback. In relation to the management of public spaces at least, the absence of robust scientific evaluation means that the standards of proof necessary to predict efficacy and ensure transferability cannot be met on the basis of current knowledge from the partner cities. Thus, examples of “good practice” are presented here at the level of “what’s promising”? (under certain circumstances) and do not make ambitious claims as to “what works” in more general terms.

Despite these caveats, an absence of local evaluation to scientific standards cannot be an excuse for inaction, or for suppressing the piloting of new ideas. There are many areas of work, for example in relation to increasing the cost of alcohol, restrictions on outlet density, restrictions on hours of sale, lower legal blood alcohol levels for driving, and identification and brief advice programmes for problem drinkers, where the evidence of success is already compelling, being supported by a convincing body of research and evaluation internationally. These are certainly good places to start.

Beyond this, one may begin to look at approaches reported in the grey literature and a smaller number of peer-reviewed studies. These would include sustained regulatory action on alcohol server responsibility (barmen, table staff ), backed by flexible, graduated sanctions; and infrastructure to support the night-time economy: effective and secure public transport; cultural events programmes to activate street life and increase the social mix; enhanced street lighting; outreach work, rapid response emergency health care, and high visibility policing by a range of state, private 43

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sector and third sector providers to increase the presence of capable guardians. As explored in the following points, these approaches, together with many others, appear to be producing safer drinking scenes in public spaces across ten, very different, European cities.

1. Density of nightlife activity

>>>>>>>>>>>>>>>

Issues arose most prominently in the case of areas which featured a density of late-night activity. This was usually the result of a high geographical concentration of nightlife venues. In other cases, the density of activity related to the hosting of major outdoor events and festivities (Stuttgart, Rotterdam, Brest), or perhaps there was a culture or tradition of spontaneous gatherings of people in outdoor spaces, such as promenades, beaches and town/city squares, on particular nights of the week. This was particularly true of university towns and resorts (La Rochelle, Brest) and was often seasonal and weather dependent. This form of spontaneous gathering has been encouraged in recent years by the rise of smartphone technologies and social media networking (Brest, La Rochelle).

High levels of street animation are perennially attractive to young people. Participation may involve visiting bars and clubs and moving between these venues, or simply being present in proximity to the bars and clubs in order to experience the heightened social atmosphere. Younger participants in the gatherings, in particular, might not be old enough or have sufficient money to access the venues, but still like to be present to join in the party atmosphere and feel as though they are “grown up�. The use of city squares for these spontaneous gatherings often conforms to the identity of such spaces and their intended functions as meeting 44

places and assembly points, the problems lie in determining, conveying and enforcing acceptable and tolerated limits for freedom of expression within such spaces that do not remove or endanger the rights of public access enjoyed by other citizens.

Access to cheap alcohol and unsupervised drinking scenes The cost differential between alcohol purchased in shops and supermarkets and that purchased in pubs, bars, nightclubs and other licensed premises was noted by several cities (La Rochelle, Reggio Emilia, Brest, Bordeaux). This was related to pre-loading at home, in public places, and on transport routes into and out of the city. Most importantly, pre-loading gave rise to reported public order and emergency health care problems, as it was the source of the great proportion of alcohol consumed in public places. This type of consumption was notably risky as the drinking was unsupervised. There was no protection from bar server responsibility training; for example, spirits consumed in public places are free poured, or “swigged” from the bottle, rather than measured by the bar server.

Moreover, there is none of the duty of care from venue management, or security staff from which customers may benefit when visiting well-supervised licensed venues. The pricing of non-alcoholic drinks in bars was also mentioned. The high prices of soft drinks did not offer an incentive to choose the non-alcoholic option.

One of the proposals currently being put forward in the UK is for the drinks manufacturers to voluntarily develop lower-alcohol content products, again, with the aim of reducing levels of harmful drinking38. Here one sees the important connections between local initiatives on alcohol and those involving national and international actors in governmental bodies and industry.

38 - Portman Group (2012), “Code of Practice for the Responsible Naming, Packaging and Promotion of Alcoholic Drinks”.

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Examples of central government strategies that can assist town and city authorities include the safe drinking guidelines for public health issued by the German and UK governments. The introduction of a minimum price per “unit” of alcohol is a further measure being considered by the governments in Scotland, England and Wales. The idea is to reflect in taxation the greater harm potentially caused to public health and wellbeing by cheap high-strength alcoholic products sold in supermarkets, as well as reducing overall alcohol consumption at population level through pricing mechanisms. The banning of irresponsible alcohol price promotions in venues (“happy hours”) applied in Kingston via the “national mandatory licensing conditions”, whilst in the Old Port area of Rotterdam a local agreement between the police and bar owners had been developed. In France, open bar practices during student nights have been prohibited by law in 2009.

2. Coordinated supportive actions

>>>>>>>>>>>>>>>

Schedule times and locations for alcohol consumption events Many events, even spontaneous / unorganised ones, could be predicted and planned for – for example, student freshers and graduation periods and examination results’ days were often part of the local annual calendar. Thus, harm prevention and minimisation measures could be organised in advance, involving universities and student unions, as well as a range of service providers. The measures might involve interventions in advance of the events, such as “safer drinking” media campaigns, working with the organisers of student parties, as well as having a visible presence 46

at the events, with trained staff (youth workers, mediators, nurses, police officers, street wardens) and volunteers on hand to offer help and advice (as in La Rochelle, Nantes, Liege).

Similar coordination and specialist planning may be useful throughout the year in relation to particular popular nightlife areas. It is important to note that the economic crisis has made drinking in bars and clubs less affordable for young people. One of the partner cities has identified three types of spontaneous or loosely-organised events: Student gatherings in a certain area, large outdoor gatherings organised via Facebook (“apéritif géant”), and open air partying following the completion of the high school baccalaureate exams.

Many of those gathered in public places may be too young to enter or purchase alcohol in the bars and clubs. They are learning how to drink and manage their alcohol intake amongst their peers, outside of the restraints imposed by adults within the family, or even within venues. In Bordeaux, Nantes, Kingston and Rotterdam there had been tragic accidents in which young people who were drunk had fallen into the local river or in the sea. This had encouraged increased emphasis on the duty of care towards young drinkers from the emergency services (including the fire brigade and river police), as well as from more informal support agencies.

Human presence / street work teams The basic principle behind the popularity of “third party policing” (policing beyond the police) across the ten cities was to increase the number of adults who are present, in addition to bar workers, door supervisors, and the police. The best initiatives of this kind combine a visible “base” facility on the street with regular foot patrols and rapid access to support vehicles, ambulances, etc. It is important that this form of “soft policing” is disassociated from more authoritarian public 47

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order policing by “the police” and that outreach staff are able to gain the trust and respect of young people by offering non-judgmental assistance that does not result in criminalisation or stigmatisation of the clients. These are often considered as mediators. Participants from Brest, La Rochelle and Liege reported that the early evening period was an important opportunity for communicating the prevention message on the streets, later at night when young people had become more intoxicated the focus turned from prevention to harm reduction. For example, in Brest these late-night interventions might include the distribution of bottled water, biscuits, and fluorescent strips.

Whilst several variants of these soft policing initiatives could be found across the SDS cities there was an urgent need expressed for better training and guidance for field agents, as well as perhaps some form of licensing and regulation that could be developed through the sharing of good practice amongst towns and cities. This would be another example of working “smart”, since evidence from Australia and the UK suggests that third party policing initiatives for nightlife are cost effective, saving the resources of both the police and emergency health care services (ambulances and hospitals).

3. Formal regulations and penalties

>>>>>>>>>>>>>>>

Police resourcing and tactical planning was an issue raised in several cities. The night-time economy was often seen as a drain on scarce resources that drew police attention away from other matters, thus affecting policing services for the wider community. In certain cities, police shifts had to be re-arranged to provide extra cover for the night-time hours (La Rochelle and 48

Nantes), specialist police teams created (Rotterdam and Bordeaux), and coordination and emergency assistance protocols between different police organisations established (La Rochelle, Brest, Nantes). Forms of regulation fell into three categories: venue-based, areabased, and individual-based.

Venue-based This can involve limiting the availability of alcohol through controls on the density of licensed premises and their hours of sale. La Rochelle now restricts the closing time of bars to 2AM due to the over-concentration of venues and their cumulative impact. In Reggio Emilia and Brest there are restrictions on the hours in which outlets can sell alcohol for people to take away.

These rules are intended to help restrict the amount of alcohol available for drinking in public places during the evening and at night. The failure of a club or bar operator to prevent crime could result in regulatory action to reduce the trading hours of the venue, or even to close the premises down (Bordeaux, La Rochelle, Kingston). All areas imposed fines on licensed premises for failing to comply with licensing legislation such as sales to minors - discovered through test purchases and other undercover operations. Bordeaux had developed the “Owl Patrol”, a team of Municipal Police who conducted up to 300 inspection visits to licensed premises in the city each year. Such enforcement activity might also include shops and neighbourhoods outside the central city. In Kingston the police conducted a “risk assessment” of any external promoter who wished to host a party in one of the city’s nightclubs.

Formal enforcement proceedings were not, however, the first course of action in most cases. The police or other authorities might first work with the management of the alcohol retailer to agree a plan of action for ensuring legal compliance and/or increasing safety 49

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and security management. In England, Kingston were able to use UK legislation to support this work with a graduated range of sanctions, including the ability to apply Conditions to the venue’s licence and bring a more thorough Review of the licence. A licence Review, for example in the case of a nightclub, might look at issues such as preventing noise nuisance, imposing lock-outs (last entry times), the venue’s dispersal policies and the number of CCTV cameras and door supervisors that should be deployed. In some cities, venues would be encouraged to support a charter (voluntary agreement) (La Rochelle, Nantes), or “Area Action Plan” for the nightlife district (Rotterdam and Antwerp).

“Alcohol Action Plan” ROTTERDAM

Issue Alcohol consumption among young people may, in the short term, cause acute poisoning or irreversible damage to their brain, which at that age is still developing. Youngsters under the age of 16 tolerate lower quantities of alcohol than adults do: a given amount of alcohol which may not be a danger to adults becomes one for a young person.

Objectives To avoid or reduce alcohol consumption by young people under the age of 16 and to avoid or reduce excessive consumption or large quantities of alcohol by young people over 16.

Activities Activities are organised along three axes: • Prevention and information: Organising activities without alcohol, such as the “FRIS50

feesten” (alcohol-free parties). Spot checks on beverages stocks are carried out at school parties and parents are encouraged to ensure no alcohol is consumed by their children beforehand. Projects such as “Safe at School” and “Healthy Schools” are aimed at educating target groups (young students) and their relations (teachers, parents).

• Supervision and enforcement: Breathalysers are offered on a voluntary basis at entrances to licensed premises and on public transport. If young people under 16 years old are found during these campaigns to be seriously under the influence, their parents are contacted. A special team (“Horecare”, which refers to the HORECA sector, i.e. hotels, restaurants and cafes) is deployed by the police in the city centre during the busy evenings of the week.

• Support and care: One of the new forms of highly accessible support which has proved to be effective is anonymous individual help via the Internet, which offers a range of e-consult programmes.

Note: the cities of Nantes and Bordeaux also carry out actions as part of a general alcohol plan.

These agreements are necessarily partnership activities that involve significant input from the operators of bars and clubs. They might typically involve the appointment of a monitoring committee, the setting of an agenda and timescale for local action, the apportionment of funding and human resources, and targets to achieve.

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Area-based The central idea behind area-based controls is to set limits and expectations, both amongst partygoers and alcohol retailers, as to what are acceptable practices within a particular designated geographical space. The aim is to avoid a worst case scenario of having to resort to public order policing methods where a crowd control situation has got out of hand. This has been the case in certain partner cities where the National Police used rubber bullets and tear gas to break up an unruly crowd attending student events. These interventions ended in unprecedented riots. A weakness of areabased controls is that problems can be displaced rather than prevented entirely. This was reported in Stuttgart, where the restrictions on people bringing their own alcohol to the Volksfest event encouraged people to over-consume alcohol in other places prior to their arrival at the event, for example at the city’s train station, which was only 100 meters from the festival site. On the other hand, in most cities, drinking scenes often are, by their nature, highly concentrated in particular places at particular times, as the function of a meeting point has become part of the historical identity of a place. In larger cities, each area attracts its own public, with different profiles. This factor can allow for the planning and targeting of interventions, whilst making geographical displacement less likely. “Controlled drinking zones�, where the consumption of alcohol in public areas is prohibited by law, were a popular policing tool (Nantes, La Rochelle, Kingston, and Bordeaux). Breaking of a ban usually results in the drinker receiving a fine and having their alcohol confiscated. In practice, the bans, like many police powers, are used with discretion, a family group in a park, taking a glass of wine with a picnic, for example, are unlikely to be penalised.

52

Cumulative Impact Policies or similar zoning policies are tools employed to control areas where the number of alcohol outlets was considered to have reached a “saturation point” beyond which the opening of further outlets, and/or their extension of opening hours into the night was considered to detract from the quality of life of the town or city (Rotterdam). This zoning policy could be as a result of crime, disorder, public nuisance, public safety concerns, or some combination of these factors.

Individual-focused Public order policing often involves issuing fines for public drunkenness, cities differed in the extent to which police resources were available to do this. It was not the fact of being drunk that attracted police attention, but only where this was judged by the police officer to be accompanied by a disturbance of the peace, causing damage, noise, or alarm and distress to others.

The notion of a “zero tolerance policing” approach to minor incivilities was not considered appropriate in any of the cities, a degree of latitude had to be given.

All of the countries had laws prohibiting the sale of alcohol to young people under a certain age and the requirement for alcohol servers to request “proof of age” from young people was more or less formal, and more or less enforced. In Stuttgart, a project aimed at young people aged 14-21 years found guilty of a crime involving alcohol, allowed parents to choose either that their child be directed towards a drug prevention and rehabilitation programme, or to have the court pronounce a criminal law penalty.

In France, the fine for public drunkenness is 135 Euros, the person is brought to the police station “drunk tank”, after passing through the hospital to check their health status. This process involves a big commitment of police resources in a context where the 53

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National Police are facing cuts in officer numbers. A number of cities are facing increasing calls from the public to deploy their Municipal Police to deal with alcohol-related crime and disorder in the city. In France, these duties are supposed to be assigned to the National Police. Here one sees the dilemma of increased demand for police resources at the same time as a restriction in supply as a result of political and economic factors at the national and international level. One way this has been taken forward is to increase partnership working between the National Police and the Municipal Police. This consideration may equally apply to Italy, which has a similar division of its national and municipal police forces.

In order to prevent repeat offending and geographical displacement there was a felt need to work with young people to change or divert their behaviour into more positive activity. This process of “Community-based”or “Social” Prevention is popular in Antwerp, Reggio Emilia, Kingston, Rotterdam and Stuttgart. In Kingston, for example, a well-equipped youth centre was available for young people to meet, socialise and access support from youth workers. This facility was located within a (relatively deprived) residential area, not within the central town. It featured, amongst other things, snooker and pool tables, a bar serving soft drinks, a recording studio, sports facilities and a simulator for testing drunk-driving. An alcohol, drugs and sexual health counsellor is also on-hand for those in need. An alcohol-free bar called Cafè Reggio, open to the public (including young people) was one initiative found in Reggio Emilia. Participants commented on the potential transferability of this idea, although a thorough evaluation over time was needed to ensure value for investment.

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“Cafè Reggio in the railway station district” REGGIO EMILIA

Issue Approximately 70% of the residents in the railway station district in Reggio Emilia are from a foreign origin and are socially disadvantaged.

In this context, certain groups or people used local parks and public spaces to meet and consume alcohol. Local citizens started making complaints. Furthermore, these gatherings had a negative impact on the image of the neighbourhood.

Objectives The objectives of this project were to help the people who consumed excessive quantities of alcohol and avoid conflicts between this population and local residents. Indirectly, improving the situation in the railway station district could only serve as an example for the rest of the city.

Activities As part of this project, several actions were undertaken such as the creation of Cafè Reggio, an alcohol-free meeting place for all local residents. The managers are part of the prevention team, which also works around the bar. This establishment offers activities for families and children. It is also used to control and monitor the area. Furthermore, a team of street mediators is in contact with local residents and provides support to people with alcohol problems.

Mediators attend regular training sessions and meet every two weeks during coordination 55

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meetings organised by the local authority which has supported the implementation of these primary prevention activities in the area.

A survey of 600 young people in Liege found that the social function of gatherings was important. Respondents said that they did not necessarily want to drink, what was important to young people was the ability to be together and socialise. The idea of diverting youthful energy and sociability towards more productive activities than simply “hanging around� had been taken up in Stuttgart where the city had a sports programme which promoted youth rehabilitation and social integration. One problem is that young people often see alcohol as synonymous with celebration, relaxation and meeting up with their friends. This is a strong cultural tradition that alcohol advertisers often aim to exploit.

Much of the street support/outreach work described above is based around a supportive non-criminalising agenda which acknowledges the important social functions of group gatherings, whilst seeking to prevent or minimise alcohol-related harms. In many ways, these were the most progressive areas of work to address the harm prevention agenda in relation to teenage drinkers, although the slightly older 18-25 year old young adult group were harder to reach in a community setting, particularly as many of them travelled into the urban centres from a wide geographical area (Stuttgart). There are opportunities here to work more closely with universities and employers around the responsible drinking message in order to access these young adults. In Antwerp, Project Breakline and Project Quality Nights focused on providing harm reduction information and support services to young adult binge drinkers and poly-substance users through cooperation with bars, clubs and festival promoters.

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“Breakline Project for prevention by peers” ANTWERP

Issue In certain party venues, drug and alcohol consumption is widespread among a public that is difficult to reach with the usual prevention actions. Information given by peers - young volunteers of the same age and from a similar background - can help young party-goers to be more vigilant about their use of drugs and alcohol.

Objectives The aim of the Breakline project is not to prevent alcohol and drug use among young people but to make them aware of the impact their use has on their health and therefore allow them to take informed decisions. As this project was implemented by peers, another objective was to collect information about substances used in order to adapt prevention messages.

Activities In 2012, volunteers to the Breakline project held support stands at nine festivals. They also organised working groups throughout the year. The project was part of an overall plan on alcohol and drugs by the city of Antwerp. Another project called “Quality Nights” was recently launched. It works through cooperation between the different teams who share their experiences and knowledge. Given the results of these two programmes, the implementation of a comprehensive training programme for peers is being considered.

In addition to direct contacts made during various parties and festivals, a website and a Facebook 57

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page are also used for communication during the project. The use of other “new media” such as YouTube videos or Bluetooth messaging would be interesting but costly.

The issue of street drinking and begging by alcohol dependent homeless people was also raised in some cities (La Rochelle, Nantes, Rotterdam, and Bordeaux).

This underlined the need to provide night shelters and access to support services providing staff trained to work with dependent drinkers (Rotterdam). Here, of course, there is the opportunity to involve street work teams established primarily to support the needs of binge drinkers visiting nightlife attractions.

Stuttgart and Kingston used “banning orders” to physically exclude violent offenders from all nightclubs and bars within the nightlife area.

“Banning orders” STUTTGART

Issue Some people may behave violently due to excessive alcohol consumption. If these partygoers become a nuisance on the premises, they may be expelled by bar and door staff.

However, Stuttgart has many bars and clubs: Troublemakers can go from one bar to another without being detected, which makes prevention more complicated.

Objectives To reduce violent behaviour due to excessive alcohol consumption and to establish an effec58

tive cooperation between local authorities, the police force and local night venues.

Actions The project is based on a network of club and bar owners and includes local police forces and a bailiff. When an individual behaves violently in a club or a bar, a report is produced and that person is not only banned from the actual bar where he/she was a nuisance, but also from every other establishment part of the network, for a period of two years. This ban is a strong deterrent. Even though it is not strictly applied, the individual returning to an establishment from which he/she was banned knows a respectful behaviour is required. When acts of violence are repeated in a second establishment, a written report is prepared by a bailiff and legal proceedings are started. All project partners in the network may display the “For a safer nightlife” poster to indicate their commitment to this project and to a better nightlife quality.

Note: A similar initiative called “Behave or be banned” has been implemented throughout the United Kingdom.

However, intentional criminality, such as street robbery involving non-participants preying upon partygoers, was not highlighted by any of the partners, although some areas had an on-street drugs trade which needed to be policed (La Rochelle, Nantes, Stuttgart).

Alcohol-related crime, disorder and nuisance are by far the major concern of the ten cities, particularly in high density nightlife areas and around public events.

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4. Urban design and service interventions

>>>>>>>>>>>>>>> CCTV is ubiquitous in a UK and Dutch context, both within bars and clubs as well as in public spaces. The situation is much different in other national contexts and cities varied as to their adoption and tolerance of this method. Reggio Emilia has obtained regional funding for cameras, alongside improved lighting in public squares and additional police surveillance of these spaces. However, there was dissent over the political acceptability of CCTV. In Kingston, CCTV operatives are linked to police and door staff on the streets via a radio link. Some cities feel that the human presence of capable guardians providing “natural surveillance� is a more important component than the use of surveillance hardware and have, as described above, made steps to ensure that this occurred. It is important here to recall the role of local residents as providers of natural surveillance and guardianship in urban spaces.

La Rochelle, as a tourist town and a student centre, reported the difficulties of finding a balance between the needs and wishes of those who wished to sleep and those who wished to party. In Bordeaux it was noted that the ban on smoking in public buildings had encouraged the use of outdoor spaces around venues where customers gathered to smoke. This was exacerbating noise nuisance for local residents who called in the Municipal Police to require venue owners to more strictly manage their outside perimeters. La Rochelle is working with bar owners to ensure that the activities of customers standing outside the venues in terraces and other open spaces do not cause harm to residents through excessive noise and disorder, and also that the bars comply with the legal rules concerning alcohol sales to minors and closing times.

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The presence of residents within a mixed-use neighbourhood that contains late-opening shops, cultural attractions and other facilities and activities, in addition to drinking in bars and clubs, offers opportunities to enhance what sociologists refer to as “community efficacy”; that is the capacity of a community to achieve resilience, neighbourliness and self-protection. If the night-time economy occupies an otherwise lifeless space within the urban fabric there is little opportunity for this community efficacy to operate. In the resultant mono-culture of the night-strip it is necessary to impose additional formal and artificial controls on visitors’ behaviour and experience shows that this is more difficult to achieve since it stands in tension with the expectations of visitors that they are entering a “pleasure zone” in which otherwise anti-social behaviour will be tolerated, or even encouraged.

Many forms of urban design and service interventions for the night-time economy are intended to address this very problem: How to manage public drunkenness in a context where it has become socially acceptable and difficult, for legal reasons, to address by reducing the availability of alcohol? Here one sees that issues of public health and public safety merge with those of crime control and city government.

Stuttgart faced conflicts between residents and visitors around the issue of illegal parking, as well as dangerous car racing at night on public roads. Road safety can become an important issue, both in the case of preventing drink-driving and in the case of planning to avoid road traffic accidents involving drunken pedestrians. Cities around the world have experimented with various methods: Barriers protecting pavement users from the highway, temporary night-time road closures (Bordeaux) and specially programmed traffic light systems. Increasing the safety and supply of late-night 61

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transport (Nantes, Bordeaux, Kingston) and ensuring that the street scene is clean and well-lit are other measures that local partnerships may undertake (La Rochelle). It is particularly important to remove glass drinking vessels and breakages from the streets as quickly as possible to avoid accidental injuries and the opportunities for glass to be used as a weapon (La Rochelle, Brest). In Kingston, the Street Pastor volunteers hand out flip-flops to female partygoers to prevent glass-related injuries to their feet when they remove their evening shoes. As recognised in Brest, the development of polycarbonate drinking vessels is a further safety measure which can prevent both accidental and criminal injury. Alcohol manufacturers and retailers may be encouraged or required to serve alcohol in nonglass containers in certain sensitive nightlife areas (Bordeaux) and in venues with a history of violence.

Sometimes a thorough cleansing of the area cannot occur until after the partygoers have left. When considering the extent of usage by people into the early morning this can be an important issue for towns and cities since it is essential that drinking detritus is removed from the public realm overnight before other users of the city arrive in daylight hours (Brest). Stuttgart seeks to remove the visibility of graffiti and vandalism on public transport in order to reduce feelings of insecurity reported to the city authorities in survey research.

Some towns and cities had developed the role of a night-time safety coordinator tasked with organising, assessing and directing the various partnership activities needed to enhance the safety of local drinking scenes through a programme of design and place management initiatives (Rotterdam, La Rochelle). Certainly, there are opportunities for cities to reclaim their night-time spaces for the majority of citizens and visitors, including older adults and families. This has been attempted in various locations internationally through 62

investment in schemes such as creative lighting and a programme of space and events management. Simple practices such as allowing shops and cafés serving soft drinks to remain open later can assist, as well as taking the opportunity to use urban spaces differently, through DIY Venues and pop-up events. The inter-generational appeal of the café in Reggio was one example of success within the SDS cities. Such responses assist in breaking down the unhelpful dichotomy that can emerge at night between well-regulated indoor spaces and unruly outdoor spaces. A key strength of the area-based controls mentioned above is that they allow city authorities to engineer such positive changes by ensuring that areas do not become monocultural drinking zones; a problem which can easily arise in the case of de-regulated spaces, where the pursuit of alcohol sales is maximised.

5. Assessing local norms

>>>>>>>>>>>>>>>>>>

Political expression ultimately decides our tolerance levels for alcohol and other substance use and misuse.

Many drinking scenes are urban public spaces which are open to use by the whole citizenry and which serve other important civic functions. A “right to the city” approach asserts that everyone has an equal right to public spaces and to decision-making around public spaces. Liege has used a process of public consultation wherein residents were surveyed about their attitudes toward local alcohol and public drinking issues. Stuttgart residents were also consulted as to their feelings of safety. The issue of ensuring that the public realm remains accessible to everyone is an important aspect of urban governance in the European context. Local authorities have a role in seeking to understand and measure public attitudes and levels of tolerance to63

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wards local drinking scenes, whilst also ensuring that the rights of minorities are protected in cases where minority interests do not cause harm to others.

One must remember that social norms are also shaped by legislation and its wording. The ability to defend locally established social norms through a political agenda will inevitably be constrained by clashes with legal strictures and economic norms, particularly as expressed by drinks manufacturers and retailers. The achievement of compliance will often involve an element of struggle and this will play out in different ways in different national and local contexts, through processes of litigation and differential access to specialist legal and scientific advice, as shaped by access to financial capacities and political alliances39. The public drunkenness issue is one in which there is rarely a consensus between stakeholders and interest groups. Once a programme of action has been set it often remains difficult to implement and to sustain over a period of time such that real measurable gains can be achieved.

Evaluation As noted in the introduction to this section, there is a general absence of scientific evaluation with regard to many of the measures put in place to prevent the harmful effects of public drunkenness. This uncertainty and the lack of public resources available to fund local independent research has created a vacuum which the drinks industry has sought to fill by developing and funding its own self-regulatory and partnership initiatives. Most schemes developed in partner cities to the SDS project have not been independently assessed by the scientific community. Whilst there may be various ways in which funding from the private sector may be 39 - Hadfield (2006), “Bar Wars: Regulating the Night in Contemporary British Cities�.

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considered for prevention activities, some of the industry-led schemes developed in the UK such as “Purple Flag” and “Best Bar None” are now being exported internationally as transferable readymade solutions. Moreover, there is good evidence internationally to suggest that self-regulation schemes do not work to prevent alcohol-related harm in the absence of a strong supportive enforcement regime. This is likely to be due, in some cases, to conflicts of interest wherein alcohol retailers operating within a competitive market become, over time, tempted to bend or break voluntarily-adopted rules.

As well as seeking to measure the effectiveness of particular initiatives within a wider programme of reducing alcohol-related harm, there is an increasing emphasis internationally on conducting local Cost v Benefit analyses. These analyses are used to compare, for example, the economic costs of providing emergency health care and policing to support the nighttime economy with an assessment of the positive economic contributions of nightlife in terms of job creation, investment, tax revenue and local prosperity.

Kingston’s “binge drinking cost assessment” has a different target, seeking to weigh the local costs of providing reactive, acute and chronic health care services with the costs of preventing alcohol-related harms through community-based council funded interventions, which seek to reduce levels of drinking. It is interesting to note that in the UK, where there are many years of experience in developing responses to public binge drinking, there is a gradual move toward viewing the problem as a public health issue (both chronic and acute). This is because the crime and disorder management approach that has dominated legislation and public discourse for so long has failed to deliver change in relation to the root causes of alcohol-related harm.

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Towards a culture of responsible alcohol consumption in Europe

>>>>>>>>>>>>>>

Alcohol is part of our society and expecting a drug-free society is utopian. Let’s recognise this fact and limit the risks and harmful effects on the younger population by moving towards accepting the reality and paradoxes surrounding alcohol consumption. The political authorities part of the SDS project hope to overcome preconceived ideas in order to protect young people from health risks, victimisation and delinquent behaviour. The study of local policies implemented by cities part of the project has revealed that they have global strategies that include education, mediation and regulation policies. Their objective is to support young people in building their personal identity and responsibility, becoming self-sufficient and acquiring skills needed to become an adult. The challenge is to address excesses associated with this consumption while promoting a responsible consumption over the long-term.

Indeed, prevention will not be effective if actions and messages are not sustained over time.

Betting on a participative approach Promoting a responsible consumption is encouraging a participative approach. In this case, cities build on individual responsibility and on the environment by targeting community involvement. The city of Antwerp, for example, supports a community-based approach which aims at supporting and educating individuals and their social network. Antwerp is a multicultural city where 66

different communities (Turkish, Moroccan and others) live alongside one another. In the “Tupper Care” project, the approach is built on the role of women. Immigrant mothers invite their neighbours, friends, acquaintances to discuss parenting and improve their understanding on drugs and their effects with the assistance of professionals. These volunteer hostesses are trained and their knowledge strengthened. They then become referents in their community on risky behaviours and issues related to drug use. They also become a point of contact within their community.

Involving the target audience reinforces the impact of the prevention message. The city of Antwerp is also involved in a participative process with the Youth Counselling Centres where young people inform their peers on drug and health issues. Because health messages are organised by peers, they are accepted and understood, which makes dissemination and communication easier. A “youth counsellor” individually supports ten youngsters who themselves become mediators. This promotes a chain reaction, increasing the number of networks and interpersonal relationships.

“We go out together, we come back together!”

As mentioned previously, the SDS project partners have been faced with tragedy, falls or accidental drowning. To support their strategy, they campaign for greater solidarity amongst the younger population for them to take care of one another. For example, one of the objectives of the city of Liege is to raise awareness among teenagers aged 12 to 18 on the dangers of alcohol consumption during the end of exam parties in the Carré district with the “Party Animals But Not Drunkards” project. Kingston upon Thames has included secondary school pupils into this communication process. Their artistic potential is then stimulated by creating prevention videos.

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All partners have agreed on the need for human presence, kind vigilance and support. The aim is not only to spread prevention and risk reduction messages but also to reduce the risk of accidents at the end of the evening. Partially basing their work on a long-term scientific study, La Rochelle has created a team of mediators as early as 2007.

“Street Action” LA ROCHELLE

Issue The project was set up following an upsurge in antisocial behaviour during gatherings at night of drunken youngsters in the city centre at weekends. This increase was highlighted by analysing complaints from residents, shopkeepers, pedestrians and tourists, but also from the conclusions of the surveillance units as well as the results of the preliminary study carried out at the launch of this action by two sociologists in 2007.

Objectives The aim is to prevent public disorder due to drunken festive gatherings and risky behaviour. It also aimed at providing a general review of the development of La Rochelle’s nightlife, leading to the production of a final charter stating everyone’s commitment to promote a health prevention approach for the younger population, but also maintaining a friendly city and encouraging peaceful coexistence among the different participants in La Rochelle’s nightlife.

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Actions To encourage dialogue and mediation between young people, bar and club managers and residents on the use of public spaces in order to reduce the feeling of insecurity and neutralise any conflictual situation. The various actors involved are committed to achieving a proper enforcement of current regulations (with regard to public order, alcohol retail and other).

They are also committed to ensuring the Nightlife Charter (which is the communication medium for various actors) is applied thanks to the team of three circulating in the city centre at night. An approach for preventing risks due to alcohol use and abuse has also been developed.

In Nantes, a team of public health professionals, community service volunteer workers and volunteers roam the streets on Thursdays, Fridays and Saturdays between 9PM and 3AM around nightlife venues.

“Evening watchmen” NANTES

Issue Given the changing consumption patterns of alcohol or psychoactive substances and the recent risk-taking activities of the youth, since 2008, the city of Nantes and the Prefecture of Loire-Atlantique have implemented the “Alcohol Plan” which combines public health and public peace. This plan was not only developed in response to health and social risks from al69

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cohol abuse, but also to deal with noise disturbances at parties and festive events.

Objectives • To reduce risk-taking linked to the use of psychoactive substances (including alcohol) amongst the younger population who attend parties or festive events.

• To work on the capacity of “living together” of young people and residents in order to reduce noise disturbances.

• To develop a prevention/risk reduction process on the use of psychoactive substances aimed at young people from disadvantaged neighbourhoods and professionals working with this population.

• To concentrate prevention on the younger population (secondary school pupils) when they gather in public spaces.

Actions The team of “Evening Watchmen” is a mobile prevention and risk reduction team. It includes public health professionals, community service volunteer workers and volunteers who roam the streets on Thursdays, Fridays and Saturdays between 9PM and 3AM around nightlife venues. By their visible (adult) presence, the team works on regulation and mediation in the public space. This approach is considered reassuring and comforting by the people they meet.

It also provides guidance and reporting depending on the assessment made of the situations encountered. Finally, the team’s observation and assessment work serves as a health monitoring system for local authorities on youth’s partying habits and how they take ownership of the public space.

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In Bordeaux, the “Soul Tram” operation is a new experimental approach taking place in the tramways: A DJ with a mobile sound system as well as prevention and risk reduction officers meet students on the tram line between the university campus and the city centre. The aim of this action is to deliver prevention messages in a favourable context, with the musical element promoting a calmer atmosphere.

“Soul Tram” BORDEAUX

Issue Increasing antisocial behaviour and the presence of groups of young people having drunk large quantities of alcohol on a specific line of the Bordeaux tramway generated a strong feeling of insecurity, especially on Thursday nights, traditional student nights. This has led the city of Bordeaux to develop a unique and attractive response aimed at students in order to regulate the behaviour of young people.

Objectives The project aimed at preventing binge drinking among young people during weekend evenings, reducing antisocial behaviour on the tram line due to this binge drinking and finally, developing innovative prevention actions towards the student audience. More moderate alcohol consumption was promoted as well as solidarity towards peers during these parties, thus reducing antisocial behaviour on the tram line service between the university campus and the city centre. This in turn would reduce the feeling of insecurity of other passengers and residents.

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Actions Between 9:30PM and 0:30AM, a mobile prevention team called “Tendance Alternative Festive” (“alternative partying”) would engage with the population using the tram line to inform them on risks. This team included professionals from the National Association for Alcohol and Addiction Prevention (ANPAA 33) and young volunteers doing their civic service, specially trained in prevention. This team is joined by a member of the Bordeaux association “Allez les filles” (“come on girls!”) (music programmer), who plays music in the trams using a mobile sound system.

With less alcohol, does the party get wilder?

Promoting a responsible consumption is suggesting alternatives. Are excesses really needed? Cities consider that recreational areas need to be designed as places that offer young people moments at which they can develop their skills and talents and where alcohol is not the only option to “have a good time”.

In Reggio Emilia, the Cafè Reggio (see above) is managed by residents alongside intercultural mediators.

It only offers non-alcoholic beverages. This café opened in a square of a working-class district that was “taken over” by groups who consumed excessive quantities of alcohol and drugs. This process has helped pacify the square and return it to its original vocation as a public space welcoming people of all ages and from all cultural backgrounds.

“Three days without alcohol”: A challenge for the adult population in Brest. Are they able to refrain from consuming alcohol for three consecutive days? Despite 72

the difficulty of assessing the impact of this action started in 1984, the Brest challenge has the merit of being creative and aimed without stigma at the entire population. Brest stated the need to meet and share the public space, and the fact that public squares must regain their function of public agora. The “Hôtel de Ville” square, a nocturnal meeting point for students, should be a symbol of this “conversation” between different generations.

Another avenue would be to ensure that individuals who do not consume alcohol are no longer considered “uncool”. A prevention policy should allow young people to make conscious decisions without moralising or demonising the product. It should promote informed consumption through a better understanding of the risks and harms resulting from excessive consumption.

Prevention versus economy Promoting a responsible consumption is managing paradoxes. A festive atmosphere contributes to the attractiveness of a city and its economy. Major festivals attract large numbers of party goers and involve a great deal of money, and incidentally beer. Their positive economic impact for manufacturers, retailers, establishments and the city makes the fight against excessive alcohol consumption and the action of elected representatives and prevention professionals more difficult. In Stuttgart, during the beer festival held each year in September (Volksfest), organisers draw attention to the risks of excessive consumption via messages on coasters and by showcasing a damaged vehicle in the car park. The site’s attractiveness for the younger population is also limited by choosing quieter music.

Faced with economic challenges as well as lobbying by the beverage industry, why not work on partnerships with the latter? Cities pondered the way of putting 73

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pressure on the beverage industry for a more responsible distribution. Alcohol producers have also understood the importance of promoting responsible drinking and have implemented various social responsibility programmes within their industry. The price of alcohol is one of the measures that need to be addressed at the European level in order to influence on the levels of consumption and on the harm resulting from excessive consumption. The same applies to measures aimed at restricting retail sales and banning advertising.

Students and partying Promoting a responsible consumption is guiding student activities which contribute to a city’s dynamics. By involving and engaging students, message among peers circulate more efficiently. Furthermore, the phenomenon and the evening routes are better understood. These local youth policies encourage young people to express themselves, take part in the collective and democratic life and build their full individuality.

In Brest, students are a component of the city, student parties too. Every summer, sixth formers celebrate the results of their baccalaureate (A-level equivalent) by gathering on a beach that cumulates several risks (railway, motorway, water and cliffs). Every service in the city, whether institution or association, is mobilised to monitor this party. Human presence adapts and switches from prevention to risk reduction later in the evening.

The beach is also supervised by zodiac boats of the gendarmerie force and of the fire and emergency services, while lighting up the ocean helps prevent accidents and drownings.

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“Risk Prevention during sixth formers’ gatherings” BREST

Issue Since June 2005, each year at the end of the baccalaureate exams, sixth formers gather spontaneously on the Moulin Blanc beach.

These gatherings include excessive drinking by certain youngsters and therefore involve significant risks for public health and safety.

Objectives To prevent risks related to alcohol abuse but also violent robberies and other intentional violence observed during the first gatherings.

To reduce the risks linked to the environment where pupils party (close to the sea, a motorway, a railway and cliffs).

Actions Various actions have been implemented: • Beforehand: In-school prevention by specialised agencies, information letters sent to parents, information stands outside schools; • During the event: Prevention and risk reduction including stands distributing biscuits and water, presence of urban mediators, integrated organisation of emergency services and civil security, tighter policing, setting up an operational command post involving the police, the gendarmerie, the Red Cross and the departmental fire and emergency services; • After the event: Site cleanup, improved street lighting, increased transport options.

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Chapter III >>>>>>>>>>>>>>>>>>>>

Observations and recommendations from the SDS project partner cities >>>>>>>>>>>>>>>>>>>>

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Considering The impact that alcohol consumption has on society; the existing tensions between generations; young people’s experimentation phase and the necessary protection of youth by society; The negative effect of alcohol experimentation and the legality of its usage; the fact that excessive alcohol consumption in public spaces by young people can lead to risks in terms of health, victimisation and nuisance to public tranquillity; That these risks are matters for concern for local authorities in terms of public security and public health; That the answers to these issues must take into account the legitimacy of partying as well as prevent excesses and risks and reconcile nightlife and citizens’ tranquillity; That local authorities wish to promote a pragmatic and operational approach targeting the protection of consumers and citizens with global, integrated partnership-based strategies; The partner cities of the SDS project underline a number of common points observed during the activities undertaken, but also recognise significant specificities in some areas. Finally, they make recommendations stemming from the SDS project.

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Observations

>>>>>>>>>>>>>>> Shared observations

• Partying as well as alcohol consumption is legitimate: Their role is to stimulate social relations, but excesses usually associated with these activities should be prevented.

• Indeed, excessive alcohol consumption entails sanitary and victimisation risks and has a negative influence on public order and the feeling of insecurity.

Common strategies • Cities develop public health and security strategies that are based on education, mediation, prevention, reduction of risks and law enforcement.

• These strategies give credit to the need to find a balance between nightlife and public peace, between public health and security.

• A cross-cutting approach is required to consider the overall phenomenon. Consumers (mostly young people), the environment (urban and social), drinking spaces (public, private, nightlife areas), drinking trends (binge drinking for example) should be taken into consideration.

• All partners and stakeholders (professionals and members of the civil society) concerned by the phenomenon must be included in the action plan.

These include parents and young people, local public services and central-State services, owners of nightlife establishments, alcohol industry, retail sector, actors in prevention, health, safety and security, culture, transport, education, etc.

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Means of intervention towards alcohol consumers • Young people being themselves actors and producers of urban tranquillity, they should be informed about the risks entailed by excessive alcohol consumption. Rules of “living together” for a civic, responsible and united youth should be set. SDS partners consider that constructive actions are those where means of intervention are given directly to the targeted group (empowerment) and in which prevention by peers is developed.

• On the one hand, local authorities favour intervention approaches such as early intervention and lifelong health education programmes, especially directed towards young people and their parents. On the other, they also support the use of regulations and appropriate law enforcement measures (such as nightlife control brigades).

• Specific spaces for the prevention of risky behaviours including, whenever possible, mobile structures dedicated to supporting and managing young people.

Understanding the phenomenon • Local authorities support actions based on practice-oriented and practice-built knowledge.

• The implementation of strategies and intervention approaches that are best fitted to a given issue require a preliminary diagnosis that all nightlife stakeholders can share and build upon (residents, young people, bar tenders and owners, foreign students, the police, third sector partners...). Each issue must be analysed according to its context and specificities, according to each different target group, etc.

Partnerships • Local authorities develop strong partnerships with health and security actors with regard to preven80

tion, mediation, risk reduction, conflict regulation and the management of public spaces.

• Partnerships with bars and nightlife establishments can be based on commitment documents such as nightlife “Charters” or “Labels”. Law enforcement can be organised collectively between local authorities and the private sector, via licensing committees.

• On the ground human presence such as mediators and reach-out workers has been highlighted as essential, strong partnerships with the civil society must be developed as the latter generally becomes coordinator of such initiatives.

Managing public spaces • Local authorities want to ensure public spaces are regulated because of public concern (and sometimes tensions) about young people occupying these public space: This raises the question of the balance to be found between prohibition and regulation.

• Defining the identity and usage of public spaces correlates with studying urban planning and urbanity. Local authorities plan situational prevention, including CCTV, by working on the urban planning based on its identity and usage.

• The use of human presence must be favoured: Police forces, mediation agents, prevention agents, volunteers.

• The need for spaces dedicated to young people must be considered without excluding the rest of the population.

Regulation • Without being in favour of a general prohibition which quickly reaches its limits, local authorities 81

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generally use regulation practices combined with prohibition measures that are limited in time and space. These practices are integrated into prevention and risk reduction approaches, and enable law enforcement (at different levels of governance).

• There are many existing regulation practices in favour of controlling, limiting and even prohibiting the consumption or sale of alcohol. Local authorities often have the regulatory competence to set closing hours for nightlife venues, prohibit alcohol consumption within a strict time and space framework or ensure national laws on legal drinking age are complied with. They can also test systems for banning problem consumers from bars.

Specific local approaches • Participative approach: Prevention and fight against alcohol-related problems can be integrated into a large citizen consultation process or be part of a study on the feeling of insecurity (Liege, Stuttgart, Rotterdam).

• Community prevention approach: Prevention messages and actions are designed to target specific communities (Antwerp, Kingston upon Thames), an approach which is for example not transferable to France.

• Nightlife charters (La Rochelle, Nantes, Bordeaux and Brest): They lay the foundations for partnerships as well as collective objectives, and safer nightlife Labels (Liege, Antwerp). These state a number of conditions to be met to obtain this accreditation.

• System for banning specific groups from nightlife venues: Implemented by the licensees themselves based on the same principle as banning violent people from football arenas (Stuttgart, Kingston upon Thames, Rotterdam).

• Use of video surveillance: Some local authorities are 82

not equipped with this tool and prefer human presence (Brest), others have tailored CCTV to their nightlife management process (Bordeaux, Rotterdam).

• Evaluation of the cost of binge drinking: Data collected from partner organisations allow a comparison between final intervention cost (cost of reparation and treatment of health problems) and prevention cost. This evaluation provides public decision makers with quality information on the potential financial benefit of their actions (Kingston upon Thames).

• Regulation initiatives such as the night control brigade (Nantes, Rotterdam, Bordeaux), and the licensing committees (French cities, Kingston upon Thames) ensure that agreements taken within the nightlife charter and licensing regulations are complied with.

• Transport policy: Specific transportation planned for party-goers (Nantes) or a mediation and harm reduction initiative taking place inside public transport (Bordeaux).

Recommendations >>>>>>>>>>>>>>> Building integrated strategies at local level • Promote an intervention concept based on the balance between public health and security; a strategy finding a balance between human presence, prevention, risk reduction, law enforcement and regulation.

• Implement a preliminary diagnosis and a study on the feeling of insecurity by means of a common questionnaire. A basic version common to all cities could be developed.

• Include “local alcohol plans” in local authorities’ 83

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safety and security and public health plans, inspired by such programmes developed in SDS cities. These plans contribute to other local authority main objectives such as preventing school dropout, fighting against violence and improving public health.

• Mobilise the partnership and organise collaborations: Manage nightlife by defining governance and collaboration methods with nightlife actors, by promoting the signing of nightlife charters and the implementation of nightlife control brigades, and by assessing the feasibility of a bars and clubs banning scheme. Strengthen collaborations with health and emergency services. The partnership dimension must take into account risk management in public spaces and the reduction of the risk of addiction.

• Organise a common culture among partners on this phenomenon by holding training and informative sessions.

• Find adequate indicators to assess the cost of prevention and that of excessive alcohol consumption.

• Strengthen schemes for assessing actions and study the impact of interventions (of prevention and security initiatives).

• Assess victimisation, crime and nuisance linked to excessive alcohol consumption in order to provide decision makers, at all level of governance, with better information on the cost/benefit analysis and priorities to be set.

Promoting responsible alcohol consumption »» Educate • Promote parenthood support initiatives, develop education and parent responsibility: Actions on young people’s psychosocial competences and strengthening parenting skills.

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• Work directly with young people: Alternatives must be created to give young people the tools for developing their skills and talents. Local authorities must offer or support alternative approaches to festive practices where alcohol is not the unique option to meet up or manage stress and problems.

• Reinforce the focus of actions on the moment when a festive consumption gives way to an excessive and abusive consumption.

• Reinforce links with other policies (Youth and Education): Spread out messages to the community to promote care for their youth, integrate young people in information and prevention processes, reinforce education in schools and support parents towards a responsible approach. »» Develop the participative approach • Involve parents so they can raise awareness among their children, especially very young ones. Implement peer support schemes in order to improve the impact of key prevention messages in the young population.

• Develop facilities open to all -teachers, teenagers and children- where information and health education is provided (example of the information centre in Reggio Emilia or mobile facilities in Antwerp and Kingston upon Thames).

• Educate professionals to detect any signs of addiction among the younger population in order to promote early care.

• Involve residents from neighbourhoods where nightlife is particularly vibrant, in an approach of co-responsibility, and focus on the feeling of insecurity.

• Build preventative measures that are adapted to foreign communities and include members of these communities.

• Promote self-regulation among consumers.

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»» Communicate • Define a responsible ethical position: What is the position of nightlife actors (institutions, third sector) on the prevention messages given by the alcohol industry on their products? Should the industry be included in prevention policies or kept at a distance?

• Define a positive communication strategy: Not presenting the person who is not drinking as “uncool”, re-thinking spaces dedicated to the youth, finding new ways of partying. Widely spread solidarity messages between young people such as “don’t drink if you are driving”, “we go out together, we come back together”.

• Involve the media in the discussion and the communication strategy regarding the position of the alcohol and retail industries.

• Have a pragmatic vision on the economic impact of alcohol sales during nightlife events and compare it with the cost sustained by Society for the reparation of harms due to excessive alcohol consumption.

European and international outlook »» A common toolbox for action • This toolbox would be developed in order to disseminate across Europe a common prevention and security culture on excessive alcohol consumption by young people in public spaces, binge drinking being a notably popular way of consuming.

• Know-how developed by local authorities can be the backbone of such a toolbox, strategies, initiatives and practices pre-exist and enable tailored responses. The approaches presented in the scope of the Safer Drinking Scenes project deserve to be valued, as they are highly transferable.

• The creation of a vade-mecum for local authorities: Local practices examined during the SDS project can 86

support other local authorities by bringing some answers, methods and tools for local policy planning with regard to excessive alcohol consumption.

• However, local authorities have noted a lack of financial resources especially for developing and promoting these prevention actions towards the younger public. Stakeholders of these initiatives must be able to prove that, across Europe, the cost of prevention is inferior to the cost of treatment and repair. »» An offer-based policy • Debate and homogenise the legal age limit for alcohol consumption in Europe; extend free availability of water in nightlife venues.

• Start a discussion with the alcohol and retail industries regarding the price of alcohol and their communication strategy towards young people and students.

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Conclusions and future prospects

>>>>>>>>>>>>>>>

Elizabeth Johnston Executive Director of the European Forum for Urban Security A common vision of nightlife The issues addressed by the Safer Drinking Scenes project have highlighted potential tensions between those who sleep, those who have fun and those who work.

Local elected officials and their teams need to find a balance and shape a common vision of what nightlife should be for everyone. This vision is developed within the city and involves health and social services officials, the police, the justice system but also the young people concerned, the alcohol industry and party organisers.

Experiments across Europe have shown that the (day and night) use of public spaces can only be examined through organised and regular consultation. This diversity must be taken into account in the design of the public space as well as in the activities it welcomes.

Public and private practitioners must be trained for the various uses made of the public space, so as to meet the needs of the different population groups through entertainment and mediation but also by reducing risks and feelings of insecurity.

Moreover, fundamental work must be carried on the issue of demand: All local partners involved in ensuring the well-being of young people need to question the expectations of these young people and the reasons why they put themselves at risk when they are otherwise socially and professionally well integrated. Some of their extreme behaviour as witnessed by experts and field workers could be a result of the hardening of our 88

society and be a symptom of their anxiety over the future that is offered to them. What leeway do teenagers have to break the rules in a society where achieving “zero risk” is the goal? While still guided by a pragmatic concern, strategies for risk reduction and prevention need to take these deeper questions into account.

Mobility and European responses Developing a common nightlife vision must be done at a local level, but also at European level. Nowadays, European cities share “their” young people through new forms of tourism and mobility. This mobility is a key factor which challenges many of the current patterns of analysis and intervention. Now that there is full European mobility, cooperation between local authorities is required. Do the young people who are drinking in the central square come from a nearby neighbourhood? Do they come from a neighbouring town in the urban community via public transport? Or from another country, via low-cost flights as part of an organised party?

How can cities welcome this opportunity while managing the pressure this type of tourism puts on local populations? Professionals are now addressing a changing audience. This requires flexibility, adaptability and innovation. There can no longer be a fixed strategy for the prevention and management of issues arising from massive alcohol consumption. Rather, it requires a corpus of expertise that will grow and evolve according to the issues encountered. On this particular topic, working with affected populations is vital to ensure messages and prevention are relevant and adapted to rapidly changing behaviours.

For a qualitative and sustainable nightlife Topics relating to the management of nightlife and excessive alcohol consumption apply to various aspects 89

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of the city and the life of the younger population. These topics are among those covered by the work carried out by the European Forum, the French Forum and their partners. Within Efus, the Safer Drinking Scenes network is part of a large corpus of work on the reduction of risks and the search for a balance between public safety and public health. It builds on the “Democracy, Cities and Drugs” networks as well as on a network of cities hosting festivals, both of which were started many years ago. The SDS network is also part of “parent” networks such as “Fêtez Clairs” and “Party +” and has links with projects coordinated by Efus such as “Managing major sporting events” and “Tourism and Security”. Thus it calls upon various professional cultures and a wide range of public, private, professional and volunteer players.

Regular meetings of the SDS project and a final conference in Nantes in June 2013 gave those involved the time and space to start developing their common vision, a culture and shared tools. The sharing of best practices and experiences has been fruitful and intense in this Safer Drinking Scenes project. The principle of the European Forum, “Cities helping cities”, was once again verified. Through this project, cities were able to take inspiration from initiatives implemented by their counterparts and adapt these to their own territory. A common European message was devised between elected representatives and professionals: The main recommendations have already been included in the Manifesto of Aubervilliers and Saint-Denis40, the political platform for Efus and its partners for the years to come.

We hope these recommendations, just as the momentum created by the SDS network, will feed into thematic networks on issues regarding health, risk reduction, security, public peace, management of public spaces, and economic and urban development. The sharing of expertise has enriched cities. Through the European Forum, we hope that other European com40 - Available at www.efus.eu

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munities can benefit from this expertise and implement these findings through the development of common tools for creating a qualitative and sustainable nightlife in Europe.

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WEBSITE OF THE SDS PROJECT www.sds-project.eu

OTHER WEBSITES French Forum for Urban Security: www.ffsu.org European Forum for Urban Security: www.efus.eu FĂŞtez Clair: www.fetez-clairs.org Party +: www.partyplus.eu

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