PHILADELPHIA – At a conference all about how college health officials can help students solve their problems, one speaker took an unexpected stance in a speech on student alcohol use and abuse: colleges can’t do much to stop it.

In a presentation Thursday at the American College Health Association’s annual meeting, Edward P. Ehlinger, director and chief health officer of Boynton Health Service at the University of Minnesota, took aim at campus-based projects intended to cut down on binge and underage drinking.

“I don’t think the problem of alcohol is an underage problem. It is not a college or university problem,” he said. “I think alcohol is a community problem -- it is a societal problem.”

Efforts like the Amethyst Initiative -- a group of college presidents who advocate for the lowering of the U.S. legal drinking age to 18 -- and the National Social Norms Institute at the University of Virginia, Ehlinger argued, aren’t working. “We have a whole bunch of efforts going on over the last 10 to 15 years,” he said, referring to these and other projects sponsored by foundations, government agencies and alcohol companies. “What have been the results? The numbers have stayed about the same.” He pointed to statistics that show that alcohol-related deaths, injuries and crimes among 18-to-24-year-olds have stayed at similar levels for years.

“We need to be humble about the fact we don’t know what the heck we’re doing and we need to do something different,” he said.

But Ehlinger’s solution isn’t a new set of college health and student services initiatives aimed at shutting down fraternity parties, arresting underage drinkers and attempting to change perceptions about how much other people drink.

Rather, it’s that colleges should work with governments and businesses to change how all Americans -- not just those who happen to be enrolled in college – think about alcohol.

Though anti-alcohol initiatives generally target college students, underage drinking, binge drinking, raucous behavior and negative consequences, Americans often think of only the last as a bad thing. “There’s no consensus that alcohol use by college students is a big problem,” Ehlinger said. Though there is agreement about preventing deaths, injuries and crimes, alumni and administrators often “hearken back to being drunk in college” and don’t see binge drinking as a problem.

And yet, underage and college drinking are where efforts to curb alcohol abuse are focused. “Folks, by focusing on underage and college students, we’re missing the boat,” he said. “I think we are being stooges for the alcohol industry. They know what we do [on these issues] is not going to impact sales; they’re fine with us doing that.”

It’s why, he said, Anheuser-Busch happily donates to projects like the National Social Norms Institute, whose executive director is James C. Turner, the current president of the ACHA and executive director of the University of Virginia’s department of student health.

(Turner later defended himself, telling the crowd assembled to hear Ehlinger that the Anheuser-Busch funding “was a gift, they said 'do what you need to do,' ” and came only after the project failed to get funding from the National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism. He left the room a few minutes later to prepare for a lecture on the norms program, which had a far smaller audience than Ehlinger's talk, despite being in a larger room.)

Though Ehlinger said he is “not an abstinence guy, I do drink myself,” he sees drastic changes in alcohol policy as essential to cutting down on dangerous drinking habits among students. He would like to see states and the federal government raise taxes on beer, wine and hard alcohol (“it’s far too cheap,” he said), and for the alcohol industry to stop advertising – especially at and during sporting events. He also wants the alcohol industry to stop funding research on drinking, which he doesn't see as credible or coming from a place of good intentions.

“These aren’t things that can be done by colleges alone,” he conceded. But, he added, “I believe that college health has a lot more power and influence than most of us realize” -- not to lead a unilateral war against underage and binge drinking, but to get politicians, health officials and business leaders to listen.

Colleges work with governments and businesses in fighting health challenges like the H1N1 virus, meningitis and tobacco use, but alcohol has yet to become a priority.

Presidents, in particular, should take the lead. “We have let our college presidents off the hook. Particularly for those of us who are at land grant institutions, we are supposed to be there for the benefit of the state,” he said. “It’s a responsibility that my university president has, as he’s the president of a land grant institution” to meet with the governor, the state legislature, the Minneapolis mayor and city council, and other government officials “to say this is a problem.”

Ehlinger favors a broader societal look at drinking, but admits that college presidents, vice presidents of student affairs and other officials will all look to college health professionals for ways to at least be seen fighting campus drinking. “We are on campuses and alcohol is taking a toll, it’s affecting us right now. We can’t just say we’re doing this policy work,” he said. “So what we should do is implement as many best practices as we can,” like clarifying norms and performing behavioral interventions.

“We need to do that, but it’s not going to change the overall numbers.”