A Systematic Review of Drink Specials, Drink Special Laws, and Alcohol-Related Outcomes.

Purpose of review: The adverse health and safety consequences of heavy alcohol consumption are a leading problem around the world. While many risk factors have been extensively studied and presented in comprehensive summaries, not all questions regarding risk factors for problematic drinking behaviors have been answered and presented in systematic reviews. As of March 2020, no review has summarized studies assessing the role of promotional price practices at on-premises alcohol outlets, known as drink specials. Also missing was systematic information of policies that regulated these promotional practices. We aimed to synthesize the available research evidence of the effects that drink specials and drink special laws have on different alcohol-related outcomes.

Recent findings: Twelve studies examined the effect of drink specials in seven countries between 1978 and 2018. Of these, 11 found a consistent positive association between drink specials and increased alcohol consumption, heavy drinking, and alcohol intoxication. Drink specials also increased reports of driving under the influence, fighting, and unprotected sex. Drink specials were also associated with expectations of higher consumption and modified attitudes and behaviors towards favorable views of drink specials. Effect sizes ranged from 1.80 to 4.43 increased odds for the examined alcohol-related outcomes. The only study examining the effects of a drink special law revealed mixed findings between prohibiting happy hours and three alcohol-related outcomes.

Summary: Drink specials were consistently associated with alcohol-related adverse outcomes, but almost nothing is known about the effects of laws restricting drink specials.