Server Intervention to Reduce Alcohol-Involved Traffic Crashes
McKnight, A James, Alcohol Health & Research World
Almost one-half of all traffic fatalities are alcohol related (National Highway Traffic Safety Administration 1995). Moreover, surveys show that up to one-half of intoxicated drivers consumed their last drink at a bar or restaurant (i.e., a licensed establishment) (McKnight 1993). In response to these findings, the view has arisen that servers of alcohol bear some responsibility for the adverse consequences of their patrons' excessive drinking. Server intervention takes many forms, primarily the withholding of service to patrons who appear intoxicated. Servers are also required to refuse service to youth below the minimum legal drinking age (MLDA), which is currently 21 in all States. Although youthfulness per se does not play as great a role in alcohol-related crashes as does intoxication, underage drivers are at greater risk for accidents when they do drink: Regardless of alcohol involvement, traffic crashes are the single leading cause of death among young adults. Efforts to encourage server intervention have taken a variety of forms, including server training, increased enforcement of laws regulating alcohol service, and the establishment of community-based programs to encourage more responsible alcohol service.
Programs designed to help servers develop the knowledge, skills, and attitudes needed for responsible serving and intervention appeared sporadically in the 1960's. During the early 1980's, server training became national in scope with the introduction of the Training for Intervention Procedures, a privately developed program marketed nationally, and the Techniques of Alcohol Management, developed by the Michigan Licensed Beverage Association. In addition, the U.S. Department of Transportation developed the Program of Responsible Alcohol Service for people and organizations interested in teaching their own courses. Within several years, server intervention training had become something of a cottage industry, with hundreds of business and public service organizations offering courses at local and State levels.
Interest in server training increased after several well-publicized cases in which the courts awarded victims of alcohol-involved crashes large sums of money at the expense of the bars and restaurants that had served the impaired drivers. Many States and localities enacted laws encouraging server training, either by mandating it directly or by limiting the liability of establishments whose servers had completed an approved course.
Research into the effectiveness of server training has yielded mixed results. Studies have demonstrated that instruction increases servers' awareness of their role in reducing the risks of drinking by underage and alcohol-impaired patrons. However, research has failed to demonstrate that servers have reduced their service of alcohol to intoxicated patrons. Controlled experiments by McKnight (1993) in eight U.S. States and by Rydon and colleagues (1996) in Australia found that servers refused service to research assistants feigning signs of intoxication no more than 10 percent of the time, regardless of whether the servers had undergone training. In a similar study, research assistants who were at the minimum legal drinking age attempted to procure alcoholic beverages in Australian establishments (Stockwell et al. 1992). Servers observed in this study attempted to verify the age of these youthful "pseudopatrons" less than onefourth of the time. Age identification studies in the U.S.-largely confined to off-premises sales-have found similarly low levels of compliance (Preusser and Williams 1991).
From a practical standpoint, the ultimate outcome for evaluating server training is its effect on traffic safety measures. Here, too, research has yielded mixed results.
Single-vehicle nighttime (SVN) crashes are commonly used as a surrogate measure of alcoholinvolved driving. Whereas Holder and Wagenaar (1994) found a decline in SVN crashes following the institution of mandatory server training in Oregon, Molof and Kimball (1994) observed no decline in SVN fatalities, alcohol-involved fatalities, or the ratio of alcohol-involved fatalities to total fatalities there. …