How to tweak liquor outlets' closing time to curb binge drinking?

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How to tweak liquor outlets' closing time to curb binge drinking?

Monday, 22 July 2024 | Mohammed Shahid Abdulla/ Manoshij Banerjee

How to tweak liquor outlets' closing time to curb binge drinking?

This article aims to explore a relationship between the closing time of liquor outlets and binge drinking behavior, hints at how the relationship functions as a socially sanctioned dark pattern, and suggests a design intervention to reduce the effect.

Binge drinking, termed a preventable public health problem by the US Centers for Disease Control and Prevention (CDC), refers to the consumption of an excessive amount of alcohol in a short time. The US National Institute on Alcohol Abuse and Alcoholism quantifies the pattern as four and five or more drinks - each standard drink is defined as containing 14 grams of pure alcohol - in about two hours for women and men, respectively. Though binge drinkers are not dependent on alcohol, the practice is harmful in its being associated with outcomes like vehicle crashes, intimate partner violence, sexual abuse, besides heart and liver disease, among others. The newest recommendations from Canada's healthcare regulator permit no more than two drinks per week - thus ruling out the office worker's weekly binge drink. In 2019, the economic burden of alcohol, on India, due to illness and productivity loss was estimated at 1.5% of GDP per year, right until 2050. As per India's National Family Health Survey 5 (NFHS-5) conducted between 2019 and 2021, alcohol consumption of men aged between 15-54 years declined by 6.1% compared to NFHS-4 in 2015-16, and that of women in the same age bracket stayed put. However, the sales of alcoholic beverages in India have grown sharply, leading many to believe that problem and binge drinkers are consuming more than ever. Even in states like Bihar, where alcohol is prohibited by law, drinking is rampant. Gujarat, a state that has been dry since its establishment in 1960, recently granted liquor licenses in GIFT City to attract financial sector establishments.

Several agencies, like the WHO and the US CDC, recommend regulating the days and hours of retail alcohol sales to reduce the harmful use of alcohol. The relationship between the closing time of liquor outlets and alcohol use, or its consequences, has been observed and documented across geographies. In Norway, an increase of an hour in bar closing was seen to increase violent crime by 16%. Alcohol bought from packaged liquor outlets during the COVID-19 lockdowns is now suspected to be the reason behind a fifth of the UK population staring at the risk of alcohol dependency. But, it is also the case that restrictions do not necessarily work. In Russia, truncated trading hours led to decreased consumption of factory-made vodka and its partial substitution by samagon (homemade vodka) by the people most exposed to the curbs. In India, the motives behind changing liquor sales hours can be quite unrelated to the risk of crime or alcohol dependence. Governments in Delhi or Uttar Pradesh, among others, have often extended sale timings for reasons ranging from helping retailers make up for business lost during COVID-19 to entertaining foreign tourists. We take a look at liquor store closing times through a behavioral lens and see how they can be tweaked (as opposed to imposed) more successfully. To simplify the problem, we will confine the discussion to a) liquor outlets selling alcohol to binge drinkers and b) only for takeaway.

Liquor outlets usually get a rush of buyers very near closing time. Perhaps the most notable example of this pattern of alcohol consumption, dubbed the 'Six o'clock Swill', is from the early 20th century when New Zealand and Australia shut their bars at 6 pm causing drinkers who finished work at 5 pm to rush and get drunk in the remaining hour. This influence has been linked intergenerationally to high per-capita alcohol consumption in these countries even to this day. The same phenomenon manifests on an extended time scale too, notice buyers in India rushing to liquor outlets before a spell of dry days, or before the 1st of a month, to stockpile booze.

We propose here that a drinking-hoarding-decisioning triad builds up to the closing time. A key motivation for bingeing is to reduce stress. Over multiple episodes of drinking, more quantities of alcohol are needed to produce the same amount of relief from stress. This is the reason why an otherwise light or moderate drinker might also graduate to binge drinking, as a recent study found. Binge and problem drinkers tend to underestimate their perceived level of inebriation too. Hence the propensity to hoard in order to drink to the point of sufficiency, as self-assessed under the effect of inebriation. Note here that sustained binge drinking is known to cause AUD and that alcohol affects right-brain functions, like emotions, highly.

The legal blood alcohol content (BAC) limit varies with jurisdiction and type of activity. Persons with BAC in the range of 0.03-0.05% (in India) or 0.03-0.08%  (in most of the US) can drive to a liquor store, even though above the minimum-measurable 0.03% they are considered inebriated and would therefore 'buying under the influence'. For illustration, if a 70 kg man has two drinks over an hour, say 9.30 PM-10.30 PM, he is likely to have a BAC of 0.04%, which still permits him to drive and make liquor purchases while inebriated, to reach the binge-drinking limit eventually. Under this reduced cognitive capacity, not all information can be attended to, hence a drinker makes decisions using only the most salient cues in their environment - a condition called alcohol myopia. We contend that the closing time of a liquor outlet is a powerful salient cue. Salient cues may either be inhibiting (There's little chance I'll get alcohol since it is nearing 11 pm - but I'll reach the store if I drive fast) or impelling (It's only 10 pm now. I can comfortably reach the store by 11 pm). It would be desirable if impelling cues outweighed inhibiting ones, persuading the drinker to drive to the store well in advance. On the contrary, recent research shows that riskier behavior is observed when choices are framed as losses (as in one possible outcome of the inhibiting cue above) as compared to gains in personal safety (as in the impelling cue above). This is called a framing effect and is enhanced by any time constraints that may be part of the cue (here it is 11 pm). Research also finds that binge drinkers prioritize alcohol-related cues or stimuli over others, demonstrating attention bias while making decisions due to a high level of craving.

This brings up another facet through which the current, typical, 11 pm closing time should be viewed. In November 2023, the Indian government issued guidelines for preventing and regulating dark patterns, mostly in the e-commerce sector. Dark patterns are defined as practices "designed to mislead or trick users to do something they originally did not intend or want to do, by subverting or impairing consumer autonomy, decision making or choice." There is an unsettling similarity between an e-commerce website nudging a user to buy a phone by "falsely creating a time-bound pressure" (quote from the guidelines) by calling the sale exclusive and the sale of alcohol to an inebriated consumer triggered by a closing time. The latter is thus tantamount to a dark pattern sanctioned by the regulator. Hence we consider the possibility of 'sludging' the consumer away from stockpiling liquor while he is inebriated.

A sludge (as opposed to a nudge) is a way to introduce friction in a user's experience to make them opt out of a process or pattern i.e. buying a high amount of alcohol just prior to closing time. We propose sludging in two variations. Firstly, since the closing time acts as a cue, making it arbitrary - and thereby less salient and floating - may reduce hoarding behavior among binge drinkers over an extended period. Assuming the current closing time is 11 pm, liquor outlets can be shut in a staggered manner i.e. 40% of outlets close at 10 pm, another 40% at 11 pm, and the last 20% at 12 midnight. The day's closing time for each outlet is decided by a daily lottery and revealed to dealers by Excise authorities only fifteen minutes before closing i.e. at 9:45 pm, 10:45 pm, and 11:45 pm, respectively. A randomization will ensure that no particular store would complain of lower revenue. The second sludging method would be to ration the alcohol that can be sold to last-minute consumers (who assemble even at these arbitrary closing times) to just a 'quarter' i.e. 180 ml, to discourage binge-drinking behavior.

As India formalizes its business and digitizes all its transactions, especially in urbanized pockets, it will also find ways to monitor all liquor sales in real time, including sales of packages beyond certain sizes. In any case, liquor sales contribute significantly to state governments' revenue and therefore the capacity to regulate them (via such sludge interventions) does exist. State Governments may also save in the long-term as their bills of healthcare burden from alcoholism, law enforcement, and the social costs of problem drinking get dialed down. As is true for most interventions, ours may also be circumvented. But, given the menace alcoholism poses to society, such an intervention may be worthwhile if only for experimentation's sake and to keep a fraction of the population from drinking itself to harm.

Mohammed Shahid Abdulla, faculty member, IIM Kozhikode and Manoshij Banerjee, independent behavioral researcher

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