A Call to Action: Changing the Culture of Drinking at U.S. Colleges

Recommendations for Colleges and Universities

"I'm in my prime drinking years, and I intend to take full advantage of it!"

- College student, after a few drinks at a wedding

Mean Score for 5+ Drinks in a Row in Past 2 Weeks by 4-year College Student StatusTwice

Once

None

College

Non-College

Wave 1 Wave 2 Wave 3 Wave 4 (18) (19-20) (21-22) (23-24)

Measurement Wave (Modal age)

Excessive Drinking During College as a “Developmental Disturbance”

Developmental disturbance features: � Time-limited deviance � Unpredictable in advance based

on individual risk factors � Not predictive of future

functioning (if you are lucky)

The 3-in-1 Framework

1. Individuals, Including At-Risk or Alcohol-Dependent Drinkers

2. Student Body as a Whole 3. College and the Surrounding

Community

Human Ecology Approach

� Individual embedded in social context

� To change behavior, best bet isto intervene at both individual and context level

� Demand and supply

Tier 2

Evidence of Success With General Populations

That Could Be Applied to College Environments

Recommendations – Tier 2

(1) Increased enforcement of minimum drinking age laws

Alcohol Use (30-day mean) Before and After Minimum Drinking Age (MDA) was Raised--United States

-3 -2 -1 1 2 3

Years Before and After MDA was RaisedYears Before and After MDA was RaisedSource: O’Malley & Wagenaar (1991)

2.2

2.4

2.6

2.8

3

3.2

Mea

n 30

Mea

n3

y A

c oho

l Use

y0 --

Da

lD

aA

lcoh

o lU

se

13% Decline13% Decline

Minimum age to 21 reduces youthful singleMinimum age to 21 reduces youthful single vehicle nighttime crashes (vehicle nighttime crashes (--20%)20%)

(O(O’’Malley and Wagenaar, 1991)Malley and Wagenaar, 1991)

Recommendations – Tier 2

(2) Implementation, increased publicity, and enforcement of other laws to reduce alcohol-impaired driving

Reduce Alcohol-Impaired Driving

� Lower legal blood alcohol limits reduces alcohol-related crashes (e.g., Hingson et al., 1996, 2000)

� Make it illegal for those under 21 to drive after any drinking

� Administrative license revocation

Recommendations – Tier 2

(3) Restrictions on alcohol retail outlet density

Local Outlet Density

� Higher levels of drinking and “binge” drinking with higher number of alcohol outlets within one mile of campus (Chaloupka & Wechsler, 1996)

� Even simple mapping may suggest interventions

Recommendations – Tier 2

(4) Increased price and excise taxes on alcoholic beverages

Pricing

� Many studies show association of price with consumption and harmful outcomes, especially for young heavy drinkers (Toomey & Wagenaar, 2002)

� For example: – Restrictions on happy hours or price

promotions

– Excise taxes on alcohol

Recommendations – Tier 2

(5) Responsible beverage service policies in social and commercial settings

Server Training and Responsible Policies (Saltz, Holder, et al.)

� Limiting sales of pitches � Alcohol-free drinks and food � No more last call � ID Checks

Alcohol-Involved Traffic Crashes Before and AfterAlcoholAlcohol--Involved Traffic Crashes Before and AfterInvolved Traffic Crashes Before and AfterMandatory Server Training Policy in Oregon, USAMandatory Server Training Policy in Oregon, USAMandatory Server Training Policy in Oregon, USA

Recommendations – Tier 2

(6) The formation of a campusand community coalition maybe critical to implement thesestrategies effectively

Community Interventions

�PRC Community Trials Project (Holder,Saltz et al.)

�Communities Mobilizing for Change(Wagenaar et al)

�Massachusetts Saving Lives Program(Hingson et al.)

Concluding Thoughts

� Try to keep major players moving in thesame direction

� Keep trying (even when you succeed)

� Involve local researchers for design andevaluation

(Extra slides from Bob Saltz follow)

Cumulative Underage Access Activities

160

140

120

100

80

60

40

20

0

ENFORCEMENT VISITS

CITATIONS ISSUED

OUTLETS TRAINED

Q2 Q3 Q4 Q1 Q2

Underage AccessUnderage Purchase Survey

-All Communities-

0

10

20

30

40

50

60

Per

cent

Sel

ling

4747 4545

5353

3535

19191616

PRETEST 1995PRETEST 1995 POSTTEST 1996POSTTEST 1996

Comparison Experimental Experimental Comparison Experimental Experimental No Training Training No Training Training

Probability of Impairment and IntoxicationProbability of Impairment and IntoxicationProbability of Impairment and IntoxicationFollowing Alcohol Beverage Server TrainingFollowing Alcohol Beverage Server TrainingFollowing Alcohol Beverage Server Training

Santa Cruz, CASanta Cruz, CASanta Cruz, CA

000

101010

202020

303030

404040

505050

Pred

icte

d P

Pred

icte

dro

babi

lity

Prob

abili

ty

TTT

CCCTTTCCC

TTT

CCCTTTCCC

ImpairmentImpairmentImpairment

IntoxicationIntoxication

PretestPretest PosttestPosttest

T = Server Training Site, C = Comparison SiteT =T = Server Training SiteServer Training Site, C =, C = Comparison SiteComparison SiteSaltz aSaltz nd Hennessy, 1990and Hennessy, 1990

Newspaper Score - Local Stories

-2

-1

0

1

2

3

4 Organizational Development and

Planning Training, Planning and 1st Media Events

Additional Training

Ongoing Advocacy Efforts

J F M AM J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J 1992 1993 1994 1995 1996

Experimental Sites Comparison Sites

Examples of Tier 2 Interventions

Northwest Region

Willamette University

� Community Task Force

� Greater Enforcement – Underage

� Training in Controlled Dispersal

University of Portland

� Community Substance Abuse PreventionTeam

� End of Finals Night

� Business Training in Marketing & Pricing

� Integrated Evaluation Data

Washington State University

� Comprehensive Community Program

� Greater Enforcement – Proactive

� Coupled with extensive Normative Education

END

Thank you!