Effects of an alcohol prevention program at sport stadiums: a 2-year follow-up study using pseudopatrons and breath alcohol concentration levels

Background: Alcohol intoxication and related problems among spectators at large sporting events is of great concern around the world. This matter has been on the agenda for Swedish authorities and key stakeholders calling for action to be taken. In response, our research group initiated a novel research project in 2015, with the aim to reduce alcohol intoxication levels and alcohol-related problems among spectators at large sport stadiums hosting games in the Swedish Premier Football League (SPFL). Prevention strategies were developed and implemented and are based on a multi-component intervention program consisting of (i) community mobilization including media advocacy, (ii) training of staff, and (iii) policy work and improved enforcement. The aim of the current study is to measure the effects of the alcohol prevention program.

Methods: This is s a quasi-experimental control group study using a repeated cross-sectional design. Data consists of security/serving staff’s frequency of denial rates towards obviously alcohol-intoxicated spectators and blood alcohol concentration (BAC) levels among spectators. Baseline data was collected in 2015 and follow-up data in 2016 and 2017. The setting was all arenas hosting SPFL games in the two largest cities in Sweden, Stockholm (intervention area) and Gothenburg (control area). Professional actors (i.e. pseudopatrons) were trained to act a standardized scene of obvious intoxication at licensed premises outside (n2015=151, n2017=148) and inside (n2015=237, n2017=258) the arenas as well as at the entrances to the arenas (n2015=102, n2017=99). Actual BAC-levels were collected among randomly selected spectators (n2015=4420, n2016=2326, n2017=3450) inside the arenas using breath analyzers.

Results: Results from the pseudopatron study in the intervention area demonstrated significant increases in denial rates towards obviously intoxicated patrons both at the entrances (from 12.9% in 2015 to 32.8% in 2017, p=.005) and at licensed premises inside the arenas (31.8% vs. 56.8%, p<.001). At licensed premises outside the arenas, the denial rates did not differ between baseline and follow-up, in line with our hypothesis. Similarly, results from the intervention area demonstrate a statistically significant decrease (p<0.001) over time on all alcohol consumption outcomes. The mean BAC-levels among spectators decreased from 0.63 in 2015to 0.57‰ in 2017. The proportion of spectators having a BAC-level >0‰ decreased from 49.7 to 42.5%, and the proportion having a BAC-level of >1.0‰ decreased from 9.7 to 5.9%.

Conclusions: Results indicate that the multi-component alcohol prevention program is effective. Analysis of data from the control area is in progress and will be compared to the intervention area in order to draw further conclusions on program effects. The intervention is still ongoing in Stockholm and other football clubs have expressed interest in the program.