Addressing Alcohol Abuse (or Not)

July 28, 2010

College students drink a lot of alcohol. Administrators try to stop them. We know this. But a new study evaluates how well colleges and universities actually address alcohol abuse on campus, and it turns out that the most effective methods aren’t the most common.

Researchers at the University of Minnesota School of Public Health followed up on recommendations made by the National Institute on Alcohol Abuse and Alcoholism in 2002. The recommendations organized alcohol-prevention strategies into four levels based on their effectiveness in curbing college drinking. (Over the past 30 years, alcohol consumption has not declined among college students, but it has declined among other adolescents and young adults.)

The NIAAA found that the most effective strategy (Tier 1) for student populations is providing one-on-one interventions for students at risk for alcohol problems. Tier 2 strategies are effective in the general population but can be applied to colleges; these include working with public officials to regulate liquor licenses in the community or ensure proper ID checks at restaurants. Tier 3 strategies have “logical and theoretical promise,” and Tier 4 are ineffective. The NIAAA detailed the strategies in each tier and provided colleges and universities nationwide with recommendations based on these findings.

Six years later, 22 percent of 351 responding institutions were unfamiliar with the recommendations, and 98 percent of colleges surveyed employed an ineffective strategy, though it wasn't clear what percentage used this strategy alone. Twenty-three percent of colleges had not implemented any Tier 1 or Tier 2 strategies, and 65 percent had implemented one or two of them. The study does not distinguish, however, between strategies that may have been implemented as a result of the 2002 NIAAA report and those that were already in place.

Percentage of Colleges Following NIAAA Recommendations

Tier 1 Intervention for at-risk students (on-campus or referred off-campus) 50%
Tier 2 Restriction on number of alcohol outlets or liquor licenses 7%
  Increased price of alcohol 2%
  Mandatory training for servers 15%
  Age compliance checks for establishments serving alcohol 33%
Tier 4 Alcohol education (lectures, online, mailings) 98%

“I think the evidence from our research suggests that schools haven’t really seriously addressed this set of recommendations,” said Toben Nelson, lead author of the study and assistant professor of epidemiology and community health. “By and large, most schools haven’t even begun the process of trying to implement them.”

Of the institutions that have utilized the NIAAA strategies, however, large schools (more than 2,500 students) make out better than small ones. Large universities are more likely to use interventions, responsibly train servers and issue compliance checks to curb underage drinking in their communities (although Nelson noted that many cities were administering these procedures without input from universities). They also were more likely to implement two or more NIAAA strategies. The study found no significant differences between public and private universities.

Nelson said that based on these data he would now like to examine whether the recommendations that have been put into place are in fact making an impact on students’ drinking behavior. It also remains to be seen where the challenges lie for the universities that don’t use the effective strategies.

But some experts say that analysis of the NIAAA recommendations should be approached with caution. Among them is James Turner, executive director of the National Social Norms Institute, who noted that the recommendations were written eight years ago, and are based on 12-year-old data. Colleges, Turner said, have changed.

According to Turner, the social norms approach to alcohol reduction on college campuses has been very effective over the past decade -- yet it was rated as a Tier 3 strategy by the NIAAA. “Over the last 10 years we have seen stunning reductions in negative consequences regarding alcohol,” he said, citing 70- to 80-percent reductions of drunk driving and binge drinking on campuses that use this approach. He added, however, that combining social norms with policies and community interaction has also proven to be effective.

And Ann Quinn-Zobeck, director of education and training for the Bacchus Network -- a university-based organization that promotes safe decisions about alcohol and tobacco -- said that, while the recommendations were based on empirical evidence, much more research has been done on intervention programs than on community strategies.



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