The European Journal of Public Health Advance Access originally published online on September 10, 2008
The European Journal of Public Health 2008 18(6):569-574; doi:10.1093/eurpub/ckn080
European Perspectives |
Predictors of violence in young tourists: a comparative study of British, German and Spanish holidaymakers
Karen Hughes1, Mark A. Bellis1, Amador Calafat2, Montse Juan2, Susanne Schnitzer3 and Zara Anderson1
1 Centre for Public Health, Liverpool John Moores University, Liverpool L3 2AY, UK
2 European Institute of Studies on Prevention (IREFREA), 07003 Palma de Mallorca, Spain
3 SPI Forschung, 10999 Berlin, Germany
Correspondence: Karen Hughes, Centre for Public Health, Liverpool John Moores University, Castle House, North Street, Liverpool L3 2AY, UK, tel: +44 (0)151 231 4510, fax: +44 (0)151 231 4515, e-mail: k.e.hughes{at}ljmu.ac.uk
Received February 29, 2008, accepted July 18, 2008
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Abstract |
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Background: International youth holiday resorts feature many of the key risk factors for violence, including large numbers of bars and nightclubs and high levels of substance use. However, little information currently exists on the extent of violence amongst holidaymakers or factors that increase risks of involvement in fights on holiday. Methods: A cross-sectional comparative survey of 3003 British, German and Spanish holidaymakers aged 16–35 years, undertaken in the departure areas of Ibiza and Majorca (Spain) airports. Results: Nightlife was the most common reason for destination choice in both locations. Overall, more than half of participants reported drinking to drunkenness at least 2 days per week during their holiday (59.3% Majorca, 58.0% Ibiza; significantly lower in Spanish participants in both locations). Levels of illicit drug use were highest in Ibiza and in British and Spanish holidaymakers. Levels of violence were highest in Majorca, where 6.4% of participants reported involvement in a fight, compared with 2.8% in Ibiza. However, after controlling for confounding factors, holiday destination was not a significant predictor of violence. Predictors of fighting were being male, young, British, frequent drunkenness and use of cannabis or cocaine during the holiday. Use of ecstasy on holiday was associated with not being involved in violence. Conclusions: High levels of substance use contribute to violence being a relatively common feature of young people's visits to international holiday resorts. To protect the health and well-being of holidaymakers and local populations in popular resorts, violence and substance use prevention must adapt to an increasingly globalized nightlife.
Keywords: alcohol consumption, drug usage, holidays, injuries, violence
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Introduction |
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Localities that contain popular nightlife areas often find their resources stretched as a result of violence linked to nightlife activity. Health services must treat injuries sustained in violent assaults; criminal justice agencies must investigate violence and prosecute offenders and local councils must deal with the fall-out of aggression, including property damage and negative impacts on businesses, regeneration and tourism.1,2 In countries where nightlife violence is a recognized problem, authorities often invest large resources in prevention, such as providing additional policing and security in nightlife areas and working with nightlife industries to develop safer environments.3–5 However, with international tourism rapidly growing,6 authorities in popular youth holiday destinations are increasingly facing the challenge of managing nightlife cultures that can be far removed from those of their native youth; in particular, problems associated with excessive substance use and violence.
Studies have shown levels of violence to be higher in areas with greater densities of drinking venues7 and that certain drinking settings experience higher levels of violence.8 Thus, venues that have more drunk patrons, uncomfortable environments (e.g. crowded, noisy) and atmospheres permissive towards anti-social behaviour (e.g. overt sexual activity, drunkenness) are linked to aggression.5,9,10 For individuals, risks of violence are typically highest in young males11 and increase with both frequency of visiting drinking venues12 and levels of alcohol consumption; those drinking more frequently, in greater quantities and to intoxication are most at risk.12–14 Illicit drugs, widely used in nightlife,15 can also contribute to violence, not only through the effects of some drugs on aggression and vulnerability,16 but also the illegal yet profitable status of drug dealing, making violence a common feature of the drug trade.17
Studies have shown holiday periods to be times of excess for young people when both alcohol and illicit drug use increase.18–20 Participation in nightlife is often a key priority for young travellers and a major factor in their destination choice.18 Consequently, to cater to the widespread demand for nightlife, youth-oriented resorts often contain concentrations of bars and nightclubs that specifically target young, partying holidaymakers. Thus, holiday resorts can feature many of the key risk factors for violence: high levels of substance use, large numbers of drinking settings targeting heavy substance-using youth and, where drug use is a feature of holiday nightlife,18 the presence of an illicit drug trade. Whilst youth-focused resorts offering ‘hedonistic’ lifestyles have been linked to higher levels of crime,21 and studies have explored general links between violence and tourism,22 few studies have specifically explored young holidaymakers’ involvement in violence in international resorts. However, the impacts of such violence can be devastating for both victims and local tourism-dependent populations.22,23
Spain is the most popular holiday destination for many young Europeans24,25 and in particular the Balearic islands of Majorca and Ibiza26 that are known for their sunshine, beaches and thriving nightlife. Media reports suggest violence is an issue in the islands’ resorts;27,28 yet, experience of violence among holidaymakers has not previously been explored. Thus, we surveyed 3003 British, German and Spanish holidaymakers (aged 16–35 years) who visited Majorca and Ibiza during the summer of 2007.
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A short, anonymous questionnaire was designed to explore the following: holidaymakers’ characteristics, experiences of violence on holiday, frequency of alcohol and drug use during the holiday and other nightlife-related factors (including features of bars/nightclubs preferred). The questionnaire was developed from pre-validated tools for surveying holiday behaviour.18,20,21 Separate questions were asked regarding arguments and fighting to ensure participants distinguished between verbal (arguments; data not analysed here) and physical aggression (fighting). To gain a measure of levels of alcohol consumption, participants were asked to identify on how many days of the week of their holiday they considered themselves to have been drunk and consequently drunkenness was self-defined. The questionnaire was tested in the United Kingdom, then translated into German and Spanish following a research meeting to ensure questions were consistent between languages.
Experienced researchers from the UK, Germany and Spain were recruited and trained to carry out the survey, which took place in the departure areas of Majorca (30 July to 5 August 2007) and Ibiza (21st–28th August 2007) airports. Both periods fell within peak European holiday season and outside of regular higher education (and most school) terms in Britain, Germany and Spain. Researchers were instructed to target all individuals that appeared to be aged 16–35 years and travelling without children or older relatives, who were waiting to check in to flights bound for the UK, Germany or Spain. Based on previous studies, a target sample of 500 participants of each nationality was set for each location.18,20,21 Spanish researchers were instructed to confirm individuals were not residents of Majorca or Ibiza before including them in the study.
Overall, 4454 individuals were approached and asked if they had time to complete a short questionnaire (Majorca: British n = 649, German n = 737, Spanish n = 655; Ibiza: British n = 750, German n = 942, Spanish n = 721). Of these, 987 (22.2%) declined before being provided with any explanation of the survey or the topics it explored (Majorca: British 15.7%, German 24.4%, Spanish 18.3%; Ibiza: British 21.2%, German 39.5%, Spanish 7.5%). Those stating they had time were provided with a survey explanation, assured of its anonymity and confidentiality and asked if they would be willing to participate. Consent was given by 95.8% (Majorca: British 98.2%, German 98.6%, Spanish 97.6%; Ibiza: British 92.6%, German 94.4%, Spanish 84.3%). Participants were handed a questionnaire, clip-board, pen and envelope and asked to self-complete the questionnaire and seal it in the envelope for collection by researchers, who were instructed to stand a discrete distance away to permit the questionnaire to be completed in private yet allow respondents to seek assistance if required.
Completed questionnaires were returned to the UK and entered into a dedicated database using SPSS v14. At this point, 252 questionnaires were excluded due to participants being outside the target age or nationality range, or for questionnaires being incomplete, inconsistent or defaced. Thus, the final sample was 3003 (Majorca: British n = 505, German n = 484, Spanish n = 487; Ibiza: British n = 528, German n = 500, Spanish n = 499). Differences between samples were analysed utilizing chi-square test and ANOVA. Chi-square test was also used to explore differences in fighting between locations, sample characteristics and bar/nightclub preferences. However, to identify predictive factors for involvement in fighting, backward conditional logistic regression was used to control for confounding factors.
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A significantly younger sample was collected in Majorca, and both age and gender varied between nationalities, with the Spanish sample being older (table 1). Length of stay and reasons for choice of holiday destination varied. While nightlife was the most popular reason overall, it was not a strong attraction for Spanish visitors to Majorca, who were more likely than other participants to have been visiting family or friends (table 1). Correspondingly, in Majorca, British and German participants visited bars/nightclubs more frequently than their Spanish counterparts, whilst in Ibiza nightlife participation was most frequent in British holidaymakers. The majority of participants had used alcohol during their holiday, although both alcohol use and reported drunkenness was lower in Spanish participants. Illicit drug use was significantly higher in Ibiza. Here, British participants were most likely to have used all drugs except cannabis and amphetamines, which were higher in Spanish participants.
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Participants were asked how frequently they had seen violence (fighting) when on nights out during their holiday. The majority (57.3%) reported never seeing fighting, 32.4% seeing it sometimes, 5.7% frequently and 4.6% every time they were out at night. Having seen fighting at least sometimes was less common in Ibiza (36.1% cf. 49.0% in Majorca, P < 0.001) and in German participants (both locations; 28.6% cf. 48.9% British, 50.4% Spanish, P < 0.001). Overall, 4.4% (n = 129) of participants had themselves been involved in a fight during their holiday. Chi-square analyses found involvement in fighting to be significantly higher among visitors to Majorca (table 2; Majorca 6.2%, Ibiza 2.8%, P < 0.001). British holidaymakers were most likely to report fighting in Majorca, while there were no differences between nationalities in Ibiza. In both locations, fighting was most common in young (age 16–19 years) males.
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Logistic regression was used to identify factors independently related to holiday violence (table 3). Here, location (Majorca/Ibiza) was not a predictive factor for fighting but the increased risks for young males were confirmed. For males, the odds of being involved in a fight were three times higher than for females, for those aged 16–19 years, odds of fighting were 4.5 times higher than for those aged 26–35 years. For British participants, odds of fighting were 1.9 times higher than for German participants. Odds of fighting almost trebled in those who had used cocaine on holiday and doubled in those who had used cannabis, whilst use of ecstasy reduced odds of fighting (OR = 0.37). Frequent drunkenness was also significantly associated with fighting (drunk on five or more days per week on holiday, OR = 2.55).
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As part of the questionnaire, participants were asked to identify from a list, features of bars/nightclubs they favoured when going out (table 4). Individuals involved in holiday violence were significantly more likely than non-fighters to favour venues that: sell cheap drinks, offer opportunities for sex, play loud music, have games (e.g. pool) and where people get drunk. Conversely, they were less likely to favour venues that: have a friendly atmosphere, are easy to get home from and have clean washrooms.
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Individuals who had been involved in violence were asked to provide more information on the circumstances of their most serious fight. Seventy-four participants provided such information (55 British, 9 German and 10 Spanish). Over three-quarters (78.4%) of reported fights involved strangers (c.f. friends 12.2%, partners 9.5%) and the majority involved opponents of the respondents’ own nationality (e.g. 66.7% of fights reported by British participants involved British opponents). Most incidents occurred at night or early morning (83.6% between 10 p.m. and 6 a.m.), almost half (47.3%) occurred at bars or nightclubs, 30.6% in streets and 26.4% in hotels. More than four in five fights occurred when participants had been drinking, although alcohol consumption prior to fighting was higher in British respondents (90.9% cf. 60.0% Spanish, 55.6% German; P < 0.01). Twelve percent of individuals providing further information on fights reported drug use prior to fighting; yet, too few provided sufficient details of substances used for further analyses. A quarter (24.3%) of all fights featured police involvement, while 17.5% resulted in the participant requiring medical treatment.
Finally, the questionnaire asked if participants thought they would return to the destination (i.e. Majorca or Ibiza) for a future holiday. Whilst the majority indicated they would (91.9% Majorca, 87.6% Ibiza, P < 0.001), individuals who had been in a fight on holiday were significantly less likely to think they would return (both locations, 74.5% cf. 90.4%; P < 0.001). Furthermore, the proportion thinking they would return decreased as the frequency of seeing fights during nights out on holiday increased; 90.5% of those never seeing fighting thought they would return compared with 76.5% of those seeing fighting every time they went out at night (P < 0.001).
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With international travel rapidly increasing,6 risky behaviour (e.g. drunkenness,29 drug use18) among young tourists is a growing concern in terms of both its impacts on holidaymakers and host countries and the international spread of such behaviours and their consequences (e.g. sexually transmitted infections30). Whilst several studies have explored substance use in young holidaymakers, few have explored their involvement in violence. As with all surveys of risky or anti-social behaviour, our study may have been influenced by compliance, under-reporting or exaggeration of violence or substance use. However, to minimize such effects, we used a methodology that informed participants of the survey's purpose, assured them of confidentiality and allowed them to self-complete questionnaires and return them through a mechanism that clearly maintained their anonymity. Amongst those informed of the survey's nature, compliance was 95.8%, while completion rates for questions on substance use and involvement in fights exceeded 94.0%.
Using a sample of over three thousand 16–35 year olds of three nationalities, we have identified violence as a relatively common feature of young people's holidays. Over two-fifths had seen violence during nights out on holiday and almost 1 in 20 (4.4%) had themselves been involved in a fight, predominantly at night, with other individuals of their own nationality after drinking alcohol. Consistent with other studies, those most likely to have been involved in violence were young males. However, there were wide variations between nationalities and holiday locations. Fighting was more prevalent among the Majorca sample and particularly among British holidaymakers. However, when confounding factors were controlled for, location of survey was not predictive of fighting. Here, besides being young, male and British, risks of holiday violence were associated with substance use, specifically frequent drunkenness and use of cannabis or cocaine.
The links between alcohol and violence are well known, with international emergency room studies suggesting between 36.0% (Spain) and 84.5% (Canada) of violent injuries are sustained following alcohol consumption.31 While alcohol use was almost universal in our sample, drinking to drunkenness was a widespread holiday activity only for British and German participants. Lower drunkenness in Spanish holidaymakers not only reflects the diverse drinking patterns across Europe32 but also suggests that Spanish authorities may have less experience of managing drunkenness in their native nightlife. Consequently, seasonal influxes of foreign holidaymakers intent on drunkenness are likely to pose significant challenges to authorities managing holiday resorts. However, drunkenness is just one factor in holiday violence. A growing number of studies are finding associations between cannabis, cocaine and violence.33–35 and our findings add to this literature base. Cannabis is the most widely used drug in Europe;36 yet, the specific links between cocaine and violence are a particular cause for concern. The prevalence of cocaine use has increased in many countries and the drug has now surpassed ecstasy to become the second most commonly used drug in Europe.36 In addition to the violence-promoting effects cocaine can have,16 its short-lived effects (
20–30 min) may increase the presence and dealing of drugs in nightlife environments as users seek repeat doses throughout the night.
In contrast to cannabis and cocaine, use of ecstasy on holiday was protective against violence, consistent with findings from other studies on ecstasy and violent crime.37 Here, whilst only 2.8% of holidaymakers to Majorca used ecstasy, in Ibiza this rose to 22.4% overall and to 44.2% in British participants. Thus, despite ecstasy use having declined in countries such as the UK and Spain,36 it remains the most popular drug among holidaymakers to Ibiza. Ibiza has a long-standing reputation for clubbing and has been credited with the introduction of ecstasy to Europe.38 With many of Europe's famous club promotions and DJs hosting regular summer events in Ibiza, the island still attracts a dedicated clubbing population, evidenced by the high levels of drug use reported in Ibiza. Thus, the protective effects of ecstasy may reflect the type of culture visitors to Ibiza represent: an older specialized clubbing set for whom ecstasy, known for its euphoric and empathic effects, forms one of a range of substances used in a dance-oriented environment. Conversely, Majorca attracts a younger, more mainstream recreational tourist population that predominantly drinks alcohol, typically to drunkenness, combined in some cases with substances linked to violence.
In addition to substance use, culture and individual characteristics, environmental factors in drinking settings can affect violence.1 To explore such issues, we asked participants what factors they favoured when choosing bars and nightclubs to visit. Here, individuals who had been involved in a fight were more likely to be attracted to venues that tolerate (e.g. lots of drunk people, easy to get sex), or even promote (cheap drinks), anti-social or indulgent behaviour. These findings are consistent with those from other studies that have typically used observational techniques to link aggression to environmental bar factors.5,9,10 Although we did not explore the types of bars holiday violence occurred in, our findings show that venues that are permissive of anti-social or indulgent behaviour (e.g. drunkenness) attract individuals who are prone to such behaviour.
Regardless of what young people seek in bars and nightclubs, when abroad, they may find situations in nightlife quite different from those at home. Little research has explored country differences in nightlife environments; yet, one study in nine European countries found that many violence prevention and alcohol harm reduction measures employed in nightlife in countries such as the UK (e.g. door supervisor training, targeted policing, licensing enforcement) are typically absent in countries such as Spain.39 Such measures can help reduce violence in aggressive drinking environments.3–5 Improved dialogue between authorities working to manage nightlife in holiday resorts and in tourists’ countries of origin should help resort authorities understand the particular issues imported through youth tourism and what measures can be effective in preventing them. Widespread implementation of nightlife-based prevention in the UK has occurred in response to high levels of drunkenness and violence; yet these continue to be major issues in UK nightlife and amongst British tourists abroad. Lower levels of drunkenness and violence in Spanish youth mean information exchange between tourists’ host and origin countries should also provide a forum for countries with violent nightlife environments to learn from those with calmer nightlife and drinking cultures. In this respect, rather than seeking to simply imitate nightlife venues, regulations and interventions from tourists’ home countries, resorts could provide ideal opportunities for spreading nightlife cultures where excessive drunkenness and violence are rejected in favour of relaxed and convivial fun.
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Between April 2005 and March 2006, 1549 British nationals were arrested in Spain, 601 were hospitalized and 41 reported rape.40 Of course, by no means all will be nightlife or violence related, yet such incidents are only the recorded tip of many more assaults and incidents of anti-social behaviour that go unnoticed by police or untreated in Spanish health services. Our results alone suggest that almost 1 in 20 of the thousands of young tourists visiting Majorca or Ibiza each year will be involved in violence, rising to 1 in 10 male holidaymakers to Majorca. While holiday resorts typically seek to protect tourists from crime,22 measures to prevent nightlife violence between holidaymakers can be less well developed. However, data presented here identify how substance use, bar management and cultural issues relating to nationality and choice of holiday destination, all affect levels of violence. Such information can form the basis of violence prevention in international resorts, including targeted policing, environmental measures (e.g. improved management of drinking venues) and health interventions aimed at tackling behaviours related to violence (e.g. frequent drunkenness). International evidence shows that they are best implemented through integrated strategies involving police, health, licensing, tourist and other local government and community representation.1 Such organizations may require resources, but in its absence, violence can rapidly escalate and result not only in individuals’ health being damaged, sometimes permanently, but also the economy suffering as a resort develops a reputation for violence. Our results identify that those experiencing or even witnessing violence on holiday are less inclined to consider returning to that location. Thus, understanding how holidaymakers can be both prevented from committing violent acts and protected from those that commit them is a fundamental element in enhancing locations’ economic success and individuals’ well-being. Accomplishing this requires multi-agency working within locations and an international network that exchanges intelligence on how violence can be managed in particular settings, the nuances that each nation's citizens bring with them when they engage in nightlife tourism and importantly the lessons that can be learnt from countries whose young revellers are less inclined to aggression.
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European Commission Directorate-General for Justice, Freedom and Security: Daphne 2006-1 (JLS/2006/Dap-1/069/Y30-CE-0117583/00-55).
Conflicts of interest: None declared.
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We thank the airport authorities in Majorca and Ibiza for their support with the project; Dan Hungerford, Gayle Whelan, Nicole Blay, Encarna Román, Margarida Ros, Joan Escandell, Daniela Völkel and Sylvia Nitschke for their assistance in data collection; Henry Edwards for his assistance with data input and all the young holidaymakers who voluntarily participated in this research. We are also grateful to the anonymous reviewers who helped improve an earlier version of this paper.
Key points
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