Mandatory Responsible Beverage Service Training in California Associated With Higher Refusals of Service to Apparently Intoxicated Patrons.

OBJECTIVE: The California (US) Responsible Beverage Service (RBS) Training Act mandated training for all alcohol servers by 2023 giving us a rare opportunity to see how a statewide initiative might influence server behavior. METHOD: In 2022, 300 licensed on-premises establishments were sampled in nine counties rep-resenting the San Francisco Bay Area. From July 2022 to January 2023, "pseudopatron" (PP) and observer teams visited each establishment, and PPs attempted to buy alcohol while displaying obvious signs of intoxication. The outcome of each purchase attempt and characteristics of establishments, servers, PPs, and month, day, and time were recorded. In 2024, the same premises were visited as a follow up. RESULTS: At baseline, 19.6% of the outlets refused service to the PP. At follow up, the refusal rate increased significantly to 39.2%in a regression model controlling for establishment, server and PP characteristics (OR= 4.51, p<.01). A typology of outlets (e.g., sports bar; casual restaurant; fine dining) did not show any association with refusal rate except that fine dining (upscale) places refused more often than other types of establishments. Observer rating of how obvious the PP's apparent intoxication was strongly associated with refusals (OR = 11.64, p<.01). CONCLUSIONS: This study suggests that there was substantial improvement in alcohol over-service refusals two years after the mandatory RBS training law went into effect.