Abstract 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.

中文翻译：

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使用合成控制的自然实验评估个人酒精许可决定对当地健康和犯罪的因果影响

摘要 背景和目标 考虑到酒精给社会带来的成本，评估当地酒精许可决定是否可以减轻酒精滥用的影响非常重要。对个人许可决定的影响进行稳健的自然实验评估可能会为当地决策提供信息和改进。我们旨在评估是否可以使用因果推理框架在小空间尺度上评估酒精许可决定。设计三个自然实验。设置和参与者 三个英语本地区域，每个区域 1000-15 000 人。干预和比较 案例研究干预是 (i) 审查后关闭一家夜总会；(ii) 在审查和 (iii) 实施新的本地许可指南 (LLG) 后关闭餐厅/夜总会。结果的趋势与使用贝叶斯结构时间序列创建的合成反事实进行了比较。测量 时间序列数据来自急诊科入院、救护车呼叫和与酒精相关的犯罪在低或中超级输出地理聚合级别。结果 夜总会关闭导致反社会行为在 4 个月内暂时减少（-18%；95% 可信区间 - 37%，-4%），其他结果没有变化。关闭餐厅/夜总会并未导致结果发生可衡量的变化。新的许可指南导致醉酒和无序行为的小幅减少（预测的 21 起事件中的 9 起被避免），并且 LLG 的计划外结束与每月两起家庭暴力事件的增加同时发生。结论 当地酒精政策的影响，即使在单个前提的层面上，也可以使用因果推理框架进行评估。关闭或限制酒类场所和酒类许可证等地方政府的行动可能会对附近地区的健康和犯罪产生积极影响。