Friday, September 9, 2016

Should colleges teach drinking 101?

A quick glance at statistics on alcohol abuse in American colleges and universities reveals a huge problem, and I believe that tackling the issue will require a new and perhaps controversial strategy. Various approaches have failed, so in this “back to school” edition I take a look at the question and offer a sensible, if counterintuitive, alternative. The majority of young people who choose to drink need to be taught that there is such a thing as healthy drinking. The drinking 101 curriculum has to include “how drinking can be healthy” and not just “don’t drink.”
First the numbers: According to the National Institute on Alcohol Abuse and Alcoholism, as many as 1800 students die each year from alcohol-related causes. More than a half million more are injured while drunk, and tens of thousands become victims of sexual assault attributable to alcohol.  Tellingly, more than half of the 80% of students who consume alcohol engage in binge drinking, and this lies at the heart of most of the problems.

Party Culture Reinforces the Role of Alcohol as a Drug

Cultural factors make the problem of college drinking intractable to the usual approaches based primarily on enforcement of drinking restrictions. As the song goes, students are willing to fight for their right to party, and it’s the party culture that reinforces the role of alcohol as a drug. According to a 2014 New York Times article, the nation’s #1 party school Syracuse University faced a revolt over efforts to curtail drinking on campus. Students labeled the school a police state, and officials backed off. On many campuses, problem drinking is endemic to the Greek system, not directly under university control.
One clue hidden in plain sight is that the abuse is almost entirely in the form of beer and liquor. This reflects a trend in how we view beer and liquor consumption as a society. A 2015 study analyzing content of beer and liquor TV commercials revealed that “partying” has become the primary theme, while not identified in ads from 20 years ago. (1) Even Dos Equis, the last holdout of a mature approach to beer marketing with their “most interesting man in the world," just replaced  him with a younger jock in order to appeal to more youthful consumers.
There is evidence-based guidance on reducing problem drinking on college campuses, but the efforts are still narrowly focused on overall reduction rather than type of alcohol. The NIAAA’s “College Alcohol Intervention Matrix” rates 60 strategies on their effectiveness, with skills training in the top tier. None of this training appears to include a discussion of wine as healthy part of a meal. Alcohol is alcohol, be aware of how much, and drink less or none. Other recommendations include higher taxes on alcohol, banning Sunday sales, and limiting happy hour promotions.

Wine Offers a Positive Alternative Model

Aside from political campaigns, negative messages generally don’t move the needle on human behavior as much as positive ones. Offering a positive healthy way to consume (at the appropriate age) seems likely to work better than stronger enforcement of prohibitions. Perhaps I was lucky in this regard; my wine “epiphany” came during a summer when I was doing a research project at UCLA, when someone brought a bottle of Chambolle-Musigny to a pre-concert picnic at the Hollywood Bowl. It enlightened me to the aesthetic virtues of drink over the anesthetic properties of alcohol. It would be years before I had the budget for good wine on a regular basis, but I saw immediately that there could be a positive and healthy approach to drinking. Obviously we can't expect to create an entire student body of wine snobs, but it is also obvious that we need a different approach. We need to promote a culture of healthy drinking.

"The dipsomaniac and the abstainer make the same mistake: They both regard wine as a drug and not as a drink."
G.K. Chesterton (1874-1936)

1. Content Themes of Alcohol Advertising in U.S. Television-Latent Class Analysis.
Morgenstern M, Schoeppe F, Campbell J, Braam MW, Stoolmiller M, Sargent JD.
Alcohol Clin Exp Res. 2015 Sep;39(9):1766-74.