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Universityanti-alcohol plan a failure?

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One of the most popular campaigns to curb alcohol use on campus hasn’t reduced student drinking and may actually have increased it, according to a new report from the Harvard School of Public Health’s College Alcohol Study. The findings clash with results that claim significant drops in risky drinking at some of the nation’s largest universities.

The new research targets “social norms” marketing campaigns, which aim to lower drinking levels by telling students that their peers actually consume far less than they might think. The campaigns have claimed success at some of the largest universities in the nation, such as the University of Virginia and the University of North Carolina.

But the Harvard study, funded by the Robert Wood Johnson Foundation, found students were drinking just as much at schools that implemented social norms programs, and often were drinking more.

'It doesn't seem to work'

“It’s simple, it’s cheap, it makes everybody look good. It makes the college look good because it says there’s less drinking there than people think,” says Henry Wechsler, director of the Harvard study. “The only problem is, it doesn’t seem to work.”

College drinking is pervasive, with 80 percent or more of students consuming alcohol. But the real issue is heavy consumption, or binge drinking, when students chug down numerous drinks on a single occasion. The National Household Survey on Drug Abuse reports some one in five Americans between the ages of 12 and 20 are binge drinkers, nearly 7 million people. And six in 10 men between 18 and 25 engage in “heavy episodic drinking” at least once a month, according to a Centers for Disease Control study. (Definitions vary as to how many drinks qualify as binge drinking.)

Social norms efforts often target students who are tempted to drink to excess, and are used on many campuses with high drinking rates. They include a broad array of posters and ads — even cards on a student’s 21st birthday — underscoring that most students drink modestly. Campaigns use basic messages that underscore responsibility and praise good behavior: “Most MSU students have 5 or fewer drinks per week,” said one campaign at Michigan State University; “Most U of A students are safe when they drink,” said a poster at the University of Arizona.

A Harvard survey of college administrators found nearly half had social norms programs at their schools. And students are aware of the messages, according to the study. Nearly 75 percent at schools using the programs had seen the posters or signs.

But the problem with these programs, Wechsler says, is that many students perceive a disconnect between what they’re told and their social realities. “These students are not stupid, they’re college students. They see what’s going on,” he says.

The study evaluated 37 schools that used social norms campaigns and 61 that didn’t, and measured seven student drinking behaviors, from casual to heavy drinking. Five of the seven behaviors showed no decline over time at schools that implemented the programs. Two behaviors — drinking within the past month and consuming 20 or more drinks within the past 30 days — showed increases at schools that used the social norms programs. Schools without the programs showed little change in behaviors, according to the study, published in the July issue of the Journal of Studies on Alcohol.

'Not real solid science'

The creators of social norms efforts dismiss the Harvard study, pointing to numerous case studies at schools where social norms programs have dramatically reduced drinking hazards. The University of Arizona reported a 28 percent decline in binge drinking; First-year students at the University of Virginia reduced their alcohol intake from three drinks a week to one.

Part of the problem, they say, is that a social norm plan must follow certain standards, with specific market research and tailoring of a program’s message to fit a particular school. They suggest Wechsler’s study allowed schools to say they were social norms users even if they lacked a formal program.

“That’s not real solid science,” says Michael Haines, director of the National Social Norms Resource Center. “To this day, as we stand here, this is the most effective program in the country. It has more data to show its efficacy than any other program out there.”

Located at Northern Illinois University — one of the first schools to adopt social norming — Haines’ center helps colleges around the country develop their own programs. Rather than preaching a specific message, he says, the goal is to tailor messages to a local environment. Because of that, he says, messages have been tailored to everything from sex and smoking to filing taxes. “Social norms is not an approach that automatically means ... abstinence or moderation,” he says. “We identify their healthy behaviors and grow more of it by feeding it back to them.”

Schools stick to campaigns

The Harvard study takes issue with a number of the success stories forwarded by Haines and his co-workers, suggesting many studies are not peer-reviewed and most focus on results at just one school. Though results have varied at the many schools that implemented full programs, most seem willing to stick with it.

“I’m very committed to the concept of social norming,” says Kim Dude, director of the Wellness Resource Center at the University of Missouri - Columbia. “It’s very important that students understand that most of their peers are making good choices.”

Her campus has used the program for five years, she says, with notable declines in heavy alcohol use and drunk driving. But that strategy is part of a larger plan to reduce drinking risks — including free taxis for drinking students and heavier crackdowns by campus police. (A new campaign this fall suggests students become less attractive to a date when they smoke or drink.)

While social norming has been key to the strategy, Dude says, different students are motivated in different ways. Positive messages work for some, but the threat of consequences might work better for others.

Another user of social norms has been the California State University at Chico, which has long endured a reputation as one of the nation’s wildest party schools. In social norming, Chico saw a chance to reverse its reputation among its own students.

“That reputation is really one of our major problems,” says Walt Schafer, a longtime sociology professor at Chico who has served as the university’s point person on alcohol issues.

Chico’s experiment with social norming was prompted two years ago after two students died in drinking-related incidents. In student surveys, the university has yet to see any notable reduction in students’ alcohol use. But a federally funded program of voluntary breath testing at Chico has shown an 11 percent drop among first-year students with detectable blood alcohol levels, and first-years are down from 6.8 drinks a week to 5.8.

As with their Missouri counterparts, Chico officials see social norms as one part of a broader strategy, which includes alcohol-free events, increasing students’ personal responsibility for parties with alcohol, and deals with local bars to reduce the number of drink specials and shorten drinking hours during events like St. Patrick’s Day.

“We’re following what is called in the field an environmental management strategy,” says Schafer, “which means that student alcohol abuse is a result of a variety of factors in the environment.”

A battle over methods

For his part, Wechsler has been a vocal advocate against binge drinking and has harshly criticized the social norms programs in the past. Critics maintain he is too strident in his approach, and has overstated the extent of the binge-drinking problem.

But one key downside to social norming, Wechsler says, is its assumption that any student body is a uniform group. Instead, he says, most students pick up drinking behaviors from their friends and those within their direct social circle. Accordingly, if a student spends time with people who drink a lot, he or she is more likely to drink a lot, too. The averages used in social norming, he suggests, have little meaning: “If you have a campus with 30,000 students, who is the average student on campus? There are many average students.”

Actually, Wechsler has advocated environmental approaches not unlike those adopted by some social norms schools, though he would rather focus on students’ supply of alcohol. For example, Wechsler would like to see more colleges do what Chico did: work to limit how alcohol is sold near their campuses. If large quantities and cheap prices were less prevalent, he argues, students would be driven to consume less. Nor, Wechsler insists, is an overall message of responsible drinking a bad one.

“You’re never going to eliminate it completely, nor do you want to eliminate having one drink with a pizza,” he says. “The issue is the kind of drinking that gets people into trouble.”

Haines is adamant, though, that availability is less important than what students are taught normal drinking behavior should be. And rather than focus on their good behavior, he says, Wechsler and his team are trying to scare kids with sky-high statistics. “It’s the ‘don’t run with a sharp stick, you’ll poke your eye out’ approach,” he says.

In that sense, the social norms debate returns to the classic battle of supply vs. demand. Social normers see students as mostly well-behaved and want to curb the thirst of those who do drink too much. Their critics worry about rising numbers on binge drinking and want to reduce the availability of alcohol.

And many schools, meanwhile, seem to want to target both sides of the equation. Says Missouri’s Dude: “The reality is, there’s no silver bullet.”