Responsible beverage server training (RBS/RBST)
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Health factors shape the health of individuals and communities. Everything from our education to our environments impacts our health. Modifying these clinical, behavioral, social, economic, and environmental factors can influence how long and how well people live, now and in the future.
Responsible beverage server training (RBST) includes efforts to educate owners, managers, servers, and sellers at alcohol establishments about strategies to avoid illegally selling alcohol to underage youth or intoxicated patrons1. RBST practices include offering customers food with drinks, delaying service to rapid drinkers, refusing service to intoxicated or underage consumers, and discouraging intoxicated customers from driving2. RBST is also sometimes called RBS or server training.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Reduced excessive drinking
Improved alcohol server practices
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced underage drinking
Reduced violence
Reduced alcohol-related crashes
What does the research say about effectiveness?
There is some evidence that responsible beverage server training (RBST) reduces harmful alcohol consumption2, 3, especially when implemented as part of a multi-component intervention4. However, additional evidence is needed to confirm effects2, 4.
RBST can improve server policies and practices and reduce the portion of patrons leaving drinking establishments intoxicated2, 3, 5, overservice to intoxicated patrons6, 7, and, in some circumstances with targeted enforcement, may reduce blood alcohol concentration (BAC) levels5. Multi-component RBST that combines server training, community coalition efforts, and enhanced enforcement reduces excessive consumption more than server training alone4. A RBST for managers that includes both online and in-person components may increase managers’ practice of written alcohol policies and their communication with staff about cutting off intoxicated patrons, but may not reduce likelihood of selling alcohol to obviously intoxicated patrons8, 9. Online RBST programs with user involvement and interactive activities can have greater impact in reducing overservice rates than in-person trainings6. Sweden-based multi-component alcohol prevention efforts including brief online RBST appear to reduce overservice at sporting events but are not likely to reduce excessive alcohol consumption among spectators7.
RBST may reduce alcohol sales to minors10 and alcohol-related violence4, 11. States with RBS laws are associated with lower fatal crash ratios but not with beer consumption compared to states without such laws12. The strength of RBS laws is not associated with self-reported binge drinking or alcohol-impaired driving13.
Clear role definition, evaluation, and feedback can also help facilitate effective RBST implementation14, 15. Stable and high-quality instruction and implementation that includes active discussions among participants may contribute to successful RBST programs6, 16.
How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples
Implementation Resources
PIRE-RBST - Pacific Institute for Research and Evaluation (PIRE). Best practices in responsible alcoholic beverage sales and service training: With model ordinance, commentary and resources. Ventura: Ventura County Behavioral Health (VCBH); 2008.
APIS - Alcohol Policy Information System (APIS). Welcome to the Alcohol Policy Information System.
ChangeLab-RBST - ChangeLab Solutions. Alcohol-Related Harms: Additional Information on Responsible Beverage Service Programs
UW WAPP-RBST - University of Wisconsin-Madison Law School. Wisconsin Alcohol Policy Project (WAPP): Responsible Beverage Server Requirements in Wisconsin. March 2015.
Footnotes
* Journal subscription may be required for access.
1 UMN-AEP - University of Minnesota Alcohol Epidemiology Program (UMN-AEP). Alcohol control policy descriptions.
2 CG-Alcohol - The Guide to Community Preventive Services (The Community Guide). Excessive alcohol consumption.
3 Jones 2011a - Jones L, Hughes K, Atkinson AM, Bellis MA. Reducing harm in drinking environments: A systematic review of effective approaches. Health & Place. 2011;17(2):508-18.
4 Brennan 2011 - Brennan I, Moore SC, Byrne E, Murphy S. Interventions for disorder and severe intoxication in and around licensed premises, 1989-2009. Addiction. 2011;106(4):706-13.
5 Fell 2017a - Fell JC, Fisher DA, Yao J, McKnight AS. Evaluation of a responsible beverage service and enforcement program: Effects on bar patron intoxication and potential impaired driving by young adults. Traffic Injury Prevention. 2017;18(6):557-565.
6 Woodall 2018 - Woodall WG, Starling R, Saltz RF, Buller DB, Stanghetta P. Results of a randomized trial of web-based retail onsite responsible beverage service training: WayToServe. Journal of Studies on Alcohol and Drugs. 2018;79(5):672-679.
7 Elgan 2021 - Elgán TH, Durbeej N, Holder HD, Gripenberg J. Effects of a multi-component alcohol prevention intervention at sporting events: a quasi-experimental control group study. Addiction. 2021.
8 Lenk 2018 - Lenk KM, Erickson DJ, Nelson TF, et al. Changes in alcohol policies and practices in bars and restaurants after completion of manager-focused responsible service training. Drug and Alcohol Review. 2018;37(3):356-364.
9 Toomey 2017 - Toomey TL, Lenk KM, Erickson DJ, et al. Effects of a hybrid online and in-person training program designed to reduce alcohol sales to obviously intoxicated patrons. Journal of Studies on Alcohol and Drugs 2017;78(2):268-275.
10 Chinman 2014 - Chinman M, Ebener P, Burkhart Q, et al. Evaluating the impact of getting to outcomes-underage drinking on prevention capacity and alcohol merchant attitudes and selling behaviors. Preventive Science. 2014;15(4):485-496.
11 Trolldal 2012 - Trolldal B, Brännström L, Paschall MJ, Leifman H. Effects of a multi-component responsible beverage service programme on violent assaults in Sweden. Addiction. 2012;108(1):89-96.
12 Fell 2016 - Fell JC, Scherer M, Thomas S, Voas RB. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs. 2016;77(2):249-260.
13 Linde 2016 - Lenk KM, Erickson DJ, Nelson TF, et al. Changes in alcohol policies and practices in bars and restaurants after completion of manager-focused responsible service training. Drug and Alcohol Review. 2018;37(3):356-364.
14 Haggard 2014 - Haggard U, Trolldal B, Kvillemo P, Guldbrandsson K. Implementation of a multicomponent responsible beverage service programme in Sweden: A qualitative study of promoting and hindering factors. Nordic Studies on Alcohol and Drugs. 2014;31.
15 Trolldal 2013 - Trolldal B, Haggard U, Guldbrandsson K. Factors associated with implementation of a multicomponent responsible beverage service program: Results from two surveys in 290 Swedish municipalities. Substance Abuse Treatment, Prevention, and Policy. 2013;8:11.
16 Ecklund 2018 - Ecklund AM, Nederhoff DM, Hunt SL, et al. Attitudes and practices regarding responsible beverage service: Focus group discussions with bar and restaurant management and staff. Journal of Drug Education. 2018;47(3-4):87-107.
17 APIS - Alcohol Policy Information System (APIS). Welcome to the Alcohol Policy Information System.
Related What Works for Health Strategies
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countyhealthrankings.org/strategies-and-solutions/what-works-for-health/strategies/responsible-beverage-server-training-rbsrbst
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countyhealthrankings.org/whatworks