Evaluating the causal impact of individual alcohol licensing decisions on local health and crime using natural experiments with synthetic controls

Frank de Vocht*, Cheryl McQuire, Alan Brennan, Matt Egan, Colin Angus, Eileen Kaner, Emma Beard, Jamie Brown, Daniela De Angelis, Nick Carter, Barbara Murray, Rachel Dukes, Elizabeth Greenwood, Susan Holden, Russell Jago, Matthew Hickman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Background and Aims: Given the costs of alcohol to society, it is important to evaluate whether local alcohol licensing decisions can mitigate the effects of alcohol misuse. Robust natural experiment evaluations of the impact of individual licensing decisions could potentially inform and improve local decision-making. We aimed to assess whether alcohol licensing decisions could be evaluated at small spatial scale by using a causal inference framework. Design: Three natural experiments. Setting and participants: Three English local areas of 1000–15 000 people each. Intervention and comparator: The case study interventions were (i) the closure of a nightclub following reviews; (ii) closure of a restaurant/nightclub following reviews and (iii) implementation of new local licensing guidance (LLG). Trends in outcomes were compared with synthetic counterfactuals created using Bayesian structural time–series. Measurements: Time–series data were obtained on emergency department admissions, ambulance call-outs and alcohol-related crime at the Lower or Middle Super Output geographical aggregation level. Findings: Closure of the nightclub led to temporary 4-month reductions in antisocial behaviour (−18%; 95% credible interval − 37%, −4%), with no change in other outcomes. Closure of the restaurant/nightclub did not lead to measurable changes in outcomes. The new licensing guidance led to small reductions in drunk and disorderly behaviour (nine of a predicted 21 events averted), and the unplanned end of the LLG coincided with an increase in domestic violence of two incidents per month. Conclusions: The impact of local alcohol policy, even at the level of individual premises, can be evaluated using a causal inference framework. Local government actions such as closure or restriction of alcohol venues and alcohol licensing may have a positive impact on health and crime in the immediate surrounding area.

Original languageEnglish
Pages (from-to)2021-2031
Number of pages11
Issue number11
Publication statusPublished - 1 Nov 2020

Bibliographical note

Publisher Copyright:
© 2020 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction


  • Alcohol licensing
  • Bayesian analysis
  • counterfactuals
  • crime
  • natural experiments
  • public health
  • synthetic controls


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