Social organization in bars: implications for tobacco control policy.

Public health policies related to alcohol generally and bars or other on-premise alcohol outlets specifically typically characterize bars as discrete and relatively homogenous units consisting of the physical setting, the server and other staff, and the patrons. The policies affecting these businesses and the people who work in or frequent them are placed in a variety of legal structures, including zoning ordinances and workplace legislation, as well as health codes at local, county, state, federal, and international levels. Policies focusing on alcohol outlets may include restrictions on types of alcohol permitted to be served, time of sales, minimum ages of patrons and servers, and other restrictions based on proximity to schools or on previous noncompliance with any restrictions (Edwards, Anderson, Babor, Casswell, Ferrenc, Giesbrecht, et al., 1994; Gliksman, Douglas, Rylett & Narbonne-Fortin, 1995; Grube, 1997; Laixuthai & Chaloupka, 1993; Mosher, 1999a, 1999b; Preusser & Williams, 1992; Wittman, 1997). In addition to restrictions on alcohol sales, bars and other alcohol outlets have been operationalized as the objects of public policies including smoke-free workplace ordinances restricting worker exposure to secondhand smoke (Moore, Lee, Antin & Martin, 2006; Moore, Lee, Martin, Todd & Chu, In Review; Weber, Bagwell, Fielding & Glantz, 2003) and violence and aggression (Graham, Osgood, Zibrowski, Purcell, Gliksman, Leonard, et al., 2004).

Since 1999 anthropologists at the Prevention Research Center in Berkeley, CA, have been analyzing the effects of one such policy--California Assembly Bill 13 (CA AB 13), a statewide ban on workplace smoking which in 1998 was applied to bars (Magzamen & Glantz, 2001)--by conducting a series of multi-method studies of tobacco policy compliance in bars in three California counties. Through extensive field observations and interviews we have identified wide variability within bars and aspects of bar culture which may greatly impact the success of these policies. These aspects may shape the likelihood of certain problematic health-related behaviors occurring in and around bars, such as heavy drinking, underage drinking, violence and aggression, risky sex, illicit drug use, and/or smoking cigarettes, as was the object of our studies. As observed in our studies, public health policies applied to bar settings may not be evenly upheld, applied, or enforced; we propose that the aspects of bar cultures identified here may impact the effectiveness of such policies as well.

In the following article, we will outline key aspects of bar cultures which bear on public health which we have identified through our ethnographic studies of bars. We specifically focus on social organization in bars. We define bars--also known as taverns or pubs--as those public institutions whose primary occupation is the sale and on-premise consumption of alcoholic beverages. We utilize the concept of social organization in its classical socio-anthropological sense, i.e. the interaction of persons in their relative social roles with the relationships between these persons. This article considers the social roles and relationships of bar patrons, staff and owners of bars as critical factors for health-related behaviors and adherence to public health policies. In our studies, these elements were found to contribute to the development and reinforcement of 1) power relations within bars, together with 2) solidarity of bar communities, the combination of which was seen to result in either resistance to or compliance with the externally-mandated tobacco control policy. Data sources for this article include observations of bar behavior and ethnographic interviews conducted in three multi-method studies of tobacco policy compliance in California bars.

Bars in the literature

In theoretical overviews on cross-cultural comparisons of alcohol use by anthropologists including Heath (1987), Mandelbaum (1965), and Marshall (1979), ethnographic research on drinking in public places has been shown to shed light on wider social phenomena including class and gender issues. Ethnicity, class, and gender are among the elements of culture thrown into high relief through analysis of behavior in bar settings (Caceres & Cortinas, 1996; Graves, Graves, Semu & Sam, 1982; Lindsay, 2006; Natkin, 1985; Smith, 1985).

Since the 1940s, research on bars has yielded important understandings of drinking behavior (Gottlieb, 1957; Harford, Feinhandler, Oleary, & Dorman, 1983; Hunt & Satterlee, 1986; Hunt & Satterlee, 1986; Katovich & Reese, 1987; Kessler & Gomberg, 1974; Macrory, 1952; Mass Observation, 1943; Room, 1972; Sykes, Rowley, & Schaefer, 1990; Sykes, Rowley, & Schaefer, 1993). Yet within this literature, ethnographic studies characterizing bar environments have been relatively scarce. Indeed, Room noted an increasing tendency for observational studies of bars and taverns to focus on quantified methods and less on traditional anthropological approaches (Room, 1981). However, while quantified methods allow for closer and more concise analyses of bar-room behaviors such as drink amount, frequency and type, or interactions between drinkers, traditional ethnographic approached have proven perhaps more conducive to elucidations of the norms, attitudes and social relations which underlie these behaviors. Cavan's (1966) ethnographic observations and interviews in a small set of bars in the city of San Francisco resulted in a description of bar behavior grounded in an analysis of bar-specific social norms, as well as a functional typology of bars. Although not focusing on drinking behaviors per se, Richards' (1963/64) ethnographic study of tavern groups in suburban New York also produced a typology of bars, or taverns, as well as descriptions of social relations within bars, while Dumont's (1967) case study of the role of one tavern in the lives of homeless men explicitly analyzed drinking behaviors as well as social roles and relations. Sulkunen and colleagues (1997) conducted ethnographic studies in a small sample of suburban Finnish pubs to analyze drinking behaviors within their socially-meaningful contexts. Spradley and Mann (1975) conducted an ethnographic case study analysis of one college bar to analyze social dynamics, in particular gender and power relations, through close and intensive observation of, and conversations with staff regarding, social behaviors, spatial relations, economic structures and gender roles. Gusfield (1981) described the implications of bar sociability on drinking and driving. Tavern epidemiologist W.B. Clark (1981) supported the merit of such "detailed studies" of bars but argued that scholars must continue to address bars in the aggregate in order to more fully understand associations between behavior and drinking settings.

Public health researchers analyzing bar-room contextual factors influencing risky health behaviors have generally followed Clark's advice by operationalizing bars as standardized units of analysis. Alcohol researchers deLint and Popham (1963) noted a need for further attention on the bar as a research site (Single, 1985), and several researchers have heeded this advice, focusing their analyses of alcohol consumption by conducting unobtrusive observations in bars (Caceres & Cortinas, 1996; Graves, Graves, et al., 1982; Harford, Feinhandler, et al., 1983; Harford & Gaines, 1981; Nusbaumer, Mauss & Pearson, 1982; Nusbaumer & Reiling, 2002). Other researchers have looked at violence and aggression (Fox & Sobol, 2000; Graham, Bernards, Osgood, Homel & Purcell, 2005; Graham, La Rocque, Yetman, Ross & Guistra, 1980; Graham & Wells, 2001; Leonard, Quigley, & Collins, 2003; Wells, Graham & West, 1998), and specifically women's experiences with aggression, often sexual aggression, in bars (Buddie & Parks, 2003; Parks, 2000; Parks, Miller Collins & Zetes-Zanatta, 1998; Testa & Livingston, 1999, 2000). As a result of increasing legislation prohibiting smoking in workplaces, including bars, researchers have more recently focused on smoking in bars (Beiner & Seigel, 1997; Lee, Moore & Martin, 2003; Moore, Lee, et al., 2006; Room, 2005; Tang, Cowling, Lloyd, Rogers, Koumjian, Stevens, et al., 2003; Tang, Cowling, Stevens & Lloyd, 2004; Weber, Bagwell, et al., 2003).