Monday, December 13, 2010

Britain and the Trouble of ‘Glassing’: A Narrow Approach to a Broad Problem – Caroline Pantridge

In recent years, an increasing amount of public health research has begun focusing on the relationship between alcohol and various forms of violence. Perhaps unsurprisingly, a high number of sexual assaults, physical assaults, and robberies occur when the perpetrator is under the influence of alcohol. While alcohol-related violence occurs around the globe, England in particular struggles with high levels. The British Crime Survey, published in 2000, put the number of alcohol-related violence incidents at 1.2 million, with half of these occurring around bars and nightclubs on weekend nights (1). England is increasingly concerned with its younger generation as they relate to these numbers, as well. In a report that looked at hospital admissions as an indicator of incidents done by the British Government’s Home Office, 6,657 people under age 18 were hospitalized for alcohol-related reasons in 1998, and this number jumped to 8,889 by 2006 (2). The same report singles out “glassing” as an alcohol-related assault of particular concern. The Home Office writes “in glassing incidents the perpetrator either thrusts a glass directly at a person’s face or body, or across it in a slapping-style motion…another common glassing approach is to throw the bottle or glass so that it becomes an exploding projectile” (2). When it comes to glassing attacks, pint glasses are most often cited in reported assaults, and up to 1,000 people a week suffer from injuries to the face as a result of such drunken attacks (2).
Increased attention is being focused on glassing by British politicians and agencies, particularly in the past year, as these realities have come to light. Though multiple proposals exist for mediating the damage done by glass, specifically, one of the current interventions gaining publicity is the development and introduction of shatterproof pint glasses (16). The use of safer vessels is a way to change an aspect of the nightlife environment that often contributes to significant injuries (1). This past February, the Home Office and Design Out Crime unveiled two innovative models. Gregory Katz writes “one has a thin bio-resin coating on the inside that strengthens it, and the other bonds two thin layers of glass together in the same way as car windshields” (8). Though still made of glass, which is most appealing to the typical beer consumer, these pints can no longer act as lethal weapons. Even if glasses crack, the resin binds the pieces together to prevent dangerous shards. Employees at Design Out Crime studied the different ways in which glasses were used to inflict harm and are touting the new prototypes as a way towards broader social change and overall safer drinking environments (2). After the pilot phase which is occurring at multiple high profile bars in order to test the safety and cost-effectiveness of the glasses, the Home Office plans to introduce the glasses on a voluntary basis (8).
While the replacement of dangerous pint glasses with safer alternatives is certainly innovative and addresses an environmental risk factor for violence, there are multiple flaws to this being a main approach for addressing alcohol-related violent incidents in England. On an intervention-specific level, the Home Office does not appear to have developed an effective way of framing and selling these new glasses to bars and nightclubs. Furthermore, on a broader level, this intervention fails to address other factors that contribute to violence in both the bar-specific environment as well as at the overall community level.
Making the Switch
One of the main issues with the shatterproof glasses intervention as it is now is the lack of a marketing plan to prompt bars to adopt the new technology. As it stands now, glasses will be made available on a voluntary basis to vendors. In order to affect any real change in the country, and to be considered an environmental change intervention, a vast majority, if not all, bars and nightclubs will have to make the switch to shatterproof glasses. By currently treating bars as essentially individual entities, it can be argued that the Home Office is relying on the Health Belief Model as the approach for creating buy-in to the glasses.
The Health Belief Model works on an individual level, in this case bar by bar, and looks at perceived susceptibility, perceived severity, perceived benefits of an action, and perceived barriers to taking that action (4). Operating under these assumptions, bar owners must consider in a rational manner the following before reaching a decision: have a number of glassing incidents occurred in recent memory? How severe were they? Were people brought to the hospital, or were confrontations easily broken up by bar staff? Finally, perceived benefits would have to be weighed, such as the creation of a safer environment, and perhaps fewer glasses to replace from general wear and tear. Perceived barriers to action can manifest in multiple forms, such as customer backlash. For bars that actually do regularly deal with violent incidents, switching glasses might create feelings of a tarnished image stemming from the admission that the bar was not particularly safe before. Perhaps more importantly, bars that recall no recent incidents or relatively mild ones will have low motivation to participate, focusing only on barriers to change given their low perceived susceptibility to conflict.
Relying on individual bars to make rational calculations about the benefits of switching to shatterproof pints, rather than more broadly requiring structural change, threatens to undermine the goal of reducing glassing incidents. While the Home Office and Design Out Crime might not be able to recognize disadvantages to making the switch, since promoting safety seems inherently desirable and advantageous, they may underestimate strong factors promoting the status quo, such as the long history and glorification of the classic pint in England, not to mention simply the inconvenience and logistical concerns that come with changing over inventory. In a recent study done by Simon Moore and his team in England bars were asked to voluntarily participate in a pilot program aimed at reducing intoxication and disorder around licensed establishments. While their study produced some interesting findings, the response rate for participation was not large enough to justify future trials. Simon et al write “problem premises cannot be relied on to voluntarily address alcohol-related harm. The only feasible recruitment method for a future trial would require the support of the police” (10). Thus, a voluntary basis policy with no real incentivizing is flawed and likely to be ineffective in promoting adoption of the glasses. Furthermore, as part of the same initiative, similar tactics need to be developed and employed with major alcoholic beverage companies, as they often furnish bars with their own distinctive pints. The government needs to consider strengthening the intervention through the use of framing theory, the process of appealing to ideals and self-interest, to ensure success.

More than the Glasses
The Design Out Crime glassing intervention is also flawed in that it fails to take into account other environmental factors within bars and other establishments that can contribute to alcohol-related violence. In order for incidents of glassing to actually diminish, not only do shatterproof glasses need to be widespread, but other precautionary changes must occur in bar environments, as well. While glasses undoubtedly inflict more severe injuries in the short term, and are thus of particular concern, other environmental factors contribute to the provocation of violence in the first place, not the least of which is levels of alcohol consumption.
There are a number of preventive measures that can be taken to reduce situational risk factors that contribute to alcohol-related violence. As it stands now, exposure to nightlife in popular urban centers is associated with higher chances of violent victimization (10). Simon Moore and his team state that “unfocused interventions are likely to be less effective than interventions that are responsive to the risks and needs of individual premises” (10). As it stands now, the shatterproof pint glasses are an unfocused intervention ironically due to their very narrow scope. Some bars could certainly benefit from more than simply a glass intervention. Research shows that victimization is more likely to occur the more alcohol people consume (1). Bar management decisions around the offering of cheap beer or shot specials can pose much larger environmental risk than simply the presence of glassware (16).
High levels of intoxication also contribute to violence perpetration in that it affects how individuals react to certain stimuli. Behavior in general is related to overall setting, triggering events, cognitive skills and thoughts, and considerations of rewards or punishments (9). Just as with victimization, perpetrators of alcohol-related violence report drinking for lengthy periods of time before their offense (9). Research on alcohol’s effects, as well as the attention-allocation model, provide reasoning for this phenomenon. Peter Giancola et al write “alcohol-induced impairment creates a narrowing or ‘myopic’ effect on attention that restricts the range of internal and external cues that can be perceived and processed” (6). As a result, people in this state often recognize only the most salient social cues, some of which may be deemed provocative, rather than the presence of subtler inhibitory cues (6) Bars must keep in mind that the environment they create through alcohol consumption, as well as other environmental factors, can contribute significantly to the risk of alcohol-related violence, since alcohol is a drug that does in fact impair judgment.
Furthermore, in the Bar Violence Study conducted in Buffalo, New York, it was found that participants characterized bars that were “smokier, higher in temperature, dirtier, darker, more crowded, and more likely to have competitive games” to be more susceptible to violent behavior (12). This study found that it was often the characteristics of the bar establishments themselves, rather than the typical clientele, that determined levels of violence (12). Given these risk factors, it is clear that more than simply pint glasses must be revised in order to decrease alcohol-related violent incidents. By focusing on glassing as a main concern, the British government should be careful not to lose sight of the more upstream issues in bar environments that contribute to violence and how they, as well, can be mediated.
Moving Further Upstream
At the heart of the matter, the major flaw of the shatterproof pint glass intervention is that it does nothing to address one of the major roots of the problem when it comes to alcohol-related violence: high levels of drinking. Thus it can be considered a very downstream approach. While not an unworthy intervention, replacing glasses looks to mediate the effects of a problematic drinking culture without attempting to remedy any of the factors that contribute to this culture. Heavy drinking frequency is significantly related to violence frequency (11). The United Kingdom, in particular, struggles with a rate of alcohol consumption that rivals fellow industrialized nations. The Wall Street Journal reported that “per capita consumption of alcohol in the U.K. rose 19% between 1980 and 2007, compared with a 13% decline for all 30 countries in the Organization for Economic Cooperation and Development” (16). Shatterproof pint glasses must be part of a comprehensive community level approach to alcohol and related violence in order to truly reduce attacks.
Currently, the biggest factor in glassings in England is likely not the glasses themselves, but, as David Jernigan of the Johns Hopkins Bloomberg School of Public Health notes, “the longer hours for pubs, cheap supermarket booze and the advent of ‘alcopops,’ premixed cocktails favored by young drinkers” (16) The general availability of cheap alcohol outside of nightclubs and other establishments is a major concern; one that threatens to severely undermine positive changes enacted by individual bars (16). In order to effectively start preventing violence, Britain must consider broader policy changes related to where alcohol is allowed to be sold, at what price, and looking at hours of operation for these establishments. Until structural changes happen on the community or nationwide level, current drinking behaviors in the country are likely to persist (7). In order for any behavior change to be feasible, and before any sort of social norming around appropriate levels of consumption can occur, the environment as a whole must be conducive. Shatterproof glasses are a miniscule component of the overall drinking scene.
Strengthening the Approach
The effectiveness of the shatterproof pint glass is dependent on its pairing with a broader view of environmental change. While there are few best practices for violence prevention, there exist quite a few for reducing alcohol consumption, the factor which is fueling much of this situational violence. The British government should focus its efforts on environmental change on three different levels, rather than just one. First of all, it must lobby for widespread use of the shatterproof glass at the most specific level. Then, it must investigate further environmental risk factors that can be reduced at the establishment level. Finally, policies must be enacted at the community or national level to address community-wide risk factors for violence. Taken together, these three tiers of environmental management can start reducing violence and create a conducive environment for behavior change around alcohol use.
Creating Buy-in
In order to significantly reduce glass attacks, the British government must create buy-in for its shatterproof glass product from bar owners on a large and widespread scale. Since legislation mandating the new technology might not be necessary or politically feasible, greater attention must be given to an effective marketing strategy. The main tenets of the strategy should include a branding approach for the glass and the values that it offers particular bar establishments, as well as a campaign to target the most influential bars in any given area first with the intervention. Reliance on the nudge effect, as well as branding effects, can broaden the scope of the intervention without provoking the possible negative reaction that ‘requiring’ shatterproof glasses might elicit.
The marketing campaign should start in the most popular nightlife destinations and pitches should be made in the relatively public arena of the city or town’s licensing board or club manager meetings. Though attention and airtime should be given to cost-effectiveness and logistical concerns, the pitch should focus on the public status that the bar can attain by being on the cutting edge of new technology, while still holding on to all the symbolic value that the traditional pint glass holds. Nudging relates to the role that social influence can have in effecting change at a community level. Richard Thaler and Cass Sunstein write in their book that “social influences come in two basic categories: the first involves information…the second involves peer pressure” (14). Peer pressure can be used to the campaign’s advantage if all the bar owners in a particular area are in the same room, especially if a few influential establishments can be won over in advance. People increasingly conform to ideas when they have to own up to their decision in public, and when influential people are seen to advocate for a particular appropriate behavior (14).
The way that information about the shatterproof pint glasses is conveyed will be crucial to their success, and this is where branding methods can come into play. Contrary to assumptions made by the Health Belief Model, for example, humans often do not make decisions in rational ways. Hence, why it might seem logical for everyone to simply adopt the safer glasses, appeals will likely have to be made on an emotional level to ensure a high level of buy-in. Douglas Evans and Gerard Hastings write “a branded message is a strategic communication designed to elicit a particular set of beneficial associations in the mind of the consumer which become linked to the brand’s identity” (5). In addition to positive associations, brands are also most successful when they are seen as offering solutions to problems. For this particular intervention, information needs to be gathered by consumers in order to determine the main criteria for a good night out on the town. After all, no one is likely to include glassing incidents as part of their end goal when going out. Once information is gathered, the Home Office and its partners need to emphasize not safety (which, though logically positive, is not particularly compelling), but rather the sentiments of fun, carefree socialization, and lack of drama that are given a chance to flourish in the absence of flying glass shards. It must be stressed that making a relatively small environmental change within the bar environment can save all consumers from a dangerous end to the night. Presenting positive imagery of vibrant night life without the presence of confrontation, pint glasses as weapons, and police or medical intervention will appeal to the idealized view in the bar owner’s mind (5-31).
Finally, in order to employ the peer pressure idea from the nudging concept, as well as invoke the concept of ownership, the Home Office should develop a physical icon that bars can post on a door or window which signifies their participation in the intervention. Once it becomes public knowledge that a certain establishment supports decreases in violence and a promotion of safety, the bar is more likely to live up to this expectation and continue using shatterproof glasses as well as encourage others to participate. The intervention can become a part of the bar’s identity (5).
Targeting More than a Glass
In order to significantly reduce alcohol-related violence, glassing included, more than just the glassware in any given bar environment must be addressed. In addition to vigorously campaigning for shatterproof pints, other preventative measures should be taken in bars, coupled with follow-up enforcement mechanisms.
The National Institute on Alcohol Abuse and Alcoholism cites the regulation of happy hour promotions as well as responsible beverage server programs for bars as promising and effective strategies in reducing alcohol abuse (13-250). In the Bar Violence Study done in Buffalo, New York which investigated situational risk factors for violent behavior, bars with staff that were trained in more responsible serving practices as well as in conflict reduction skills demonstrated “fewer instances of severe aggression by patrons” post-training (12). Tighter regulations around the serving of intoxicated persons and more information for bartenders and bouncers on defusing tensions can help prevent situations from escalating, shatterproof glasses or not.
Aside from staff, bar environments can be physically altered to promote healthier socialization and relaxation rather than confrontation. Tracey Budd writes about how people “can be primed into certain forms of behavior by offering simple and apparently irrelevant cues”(1) By the same token, bars with more lighting, decreased crowd sizes and cleaner facilities might be interpreted as less accepting of violence. The attention-allocation model postulates that due to the effects of alcohol myopia, attention can become focused on a narrow set of social cues. Thus, it is important that these cues signify a distraction from aggressive behavior rather than a provocation (6) Trained staff members can provide this distraction to an extent, as can other environmental factors. Peter Giancola and his team point to laboratory studies that found that “adding mirrors and video cameras to a room was effective in suppressing aggression towards others” since “the person is forced to compare their initial impulse to aggress with personal and social norms that admonish such inappropriate behavior” (6). Bar management strategies can thus be effective in reducing violence, if enforced.
Enforcement of stricter bar regulations must be part of a more comprehensive intervention along with the shatterproof glasses. The city of Cardiff in England has had success with this system. Their police force documents assaults and disturbances at local establishments and places them in a “red zone” if their numbers get too high. Improvement plans are then developed by the police which include installing more cameras and employing more bouncers and other personnel (16). Since enacting these policies, “better pub management has helped cut alcohol-related crime and disorder inside Cardiff’s pubs and clubs from 2,442 incidents in 2006 to 1,552 in 2008” (16). British officials should take notice of this decline and attempt to implement similar measures on a broader national scale.
Community Level Change
To truly start tackling the problem of glass attacks, community level policies must be enacted to start the transformation of the drinking culture and further ready the stage for further reaching behavior change among the masses. Proven policy strategies including restricting bar hours and alcohol availability, increasing drink prices, and consistent enforcement should be the focus of the British government’s overall approach to alcohol-related violence (13).
Restricting alcohol availability is necessary not only to ensure that patrons frequenting bars cannot continue drinking indefinitely, but also to reduce the number that show up already quite intoxicated from liquor easily obtained elsewhere. Mary McMurran and her team found that most alcohol-related incidents that they studied occurred in the middle of the night, or between 11pm and 2am (9). Enforcing bar closing times within this window is likely to cut down on risky scenarios, as has been proven in various studies including one done in Brazil in which monthly assaults fell from 48 to 25 per month after a new law mandating bars to close at 11pm took effect (3-2278). Raising alcohol taxes and prices is also an effective tactic in reducing alcohol-related consequences. Alexander Wagenaar and his team found that, in an aggregation of studies involving alcohol and price points, higher prices were “significantly and inversely related to all outcome categories examined, including alcohol-related…violence, traffic crash fatalities and drunk driving, rates of STDs…drug use, and crime” (15). These strategies have also been found effective by the NIAAA in the United States. Once again, the British Government must take a more sweeping and ambitious approach in order to decrease violent behaviors.
A community-level, comprehensive environmental management approach must be prioritized and undertaken by the United Kingdom in order to effect any real positive change in alcohol-related violence. Community-wide interventions are a proven strategy (7). While shatterproof pint glasses represent an innovative and even beneficial approach to the problem of glassing, they must be used widely and in tandem with other more upper level policy approaches.
1. Budd, Tracey. “Alcohol-Related Assault: Findings from the British Crime Survey.” Home Office Online Report. 2003: p. 1-31.
2. Design Council. “Design out Crime: Using Design to Reduce Injuries from Alcohol-Related Violence in Pubs and Clubs.” Alliance Against Crime, 2010.
3. Duailibi, Sergio and William Ponicki, et al. “The Effect of Restricting Opening Hours on Alcohol-Related Violence.” American Journal of Public Health. 2007: p. 2276-2280.
4. Edberg, Mark. Essentials of Health Behavior: Social and Behavioral Theory in Public Health. Sudbury, MA: Jones and Bartlett Publishers, 2007.
5. Evans, Douglas and Gerard Hastings. Public Health Branding: Applying Marketing for Social Change. Oxford: University Press, 2008.
6. Giancola, Peter and Robert Josephs, et al. “Applying the Attention-Allocation Model to the Explanation of Alcohol-Related Aggression: Implications for Prevention.” Substance Use and Misuse. 2009: p. 1263-1279.
7. Holder, Harold. “Community Prevention of Young Adult Drinking and Associated Problems.” NIAAA Alcohol Research and Health. 2005: p. 245-248.
8. Katz, Gregory. “Shatterproof Pint Glass Unveiled by British Government.” Huffington Post. 4 Feb 2010.
9. McMurran, Mary and Mary Jinks, et al. “Alcohol-Related Violence Defined by Ultimate Goals: A Qualitative Analysis of the Features of Three Different Types of Violence by Intoxicated Young Male Offenders.” Aggressive Behavior. 2010: p. 67-79.
10. Moore, Simon and Iain Brennan, et al. “The Reduction of Intoxication and Disorder in Premises Licensed to Serve Alcohol: An Exploratory Randomized Controlled Trial.” BMC Public Health. 2010: p. 607-615.
11. Norstrom, Thor and Hilde Pape. “Alcohol, Suppressed Anger and Violence.” Addiction. 2010: p. 1580-1586.
12. Quigley, Brian and Kenneth Leonard. “Alcohol Use and Violence Among Young Adults.” NIAAA Alcohol Research and Health. 2005: p. 191-194.
13. Saltz, Robert. “Preventing Alcohol-Related Problems on College Campuses.” NIAAA Alcohol Research and Health. 2005: p. 249-251.
14. Thaler, Richard and Cass Sunstein. Nudge: Improving Decisions about Health, Wealth, and Happiness. New Haven: Yale University Press, 2008.
15. Wagenaar, Alexander and Amy Tobler, et al. “Effects of Alcohol Tax and Price Policies on Morbidity and Mortality: A Systematic Review.” American Journal of Public Health. 2010: p. 2270-2278.
16. Whalen, Jeanne. “UK Drinking Problem Gets Political.” The Wall Street Journal. 8 April 2010.

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