John McAlaney

Adult Consequences of Late Adolescent Alcohol Consumption: A Systematic Review of Cohort Studies

In a systematic review of cohort studies of adolescent drinking and later outcomes, Jim McCambridge and colleagues show that although studies suggest links to worse adult physical and mental health and social consequences, existing evidence is of poor quality.

Change over time in alcohol consumption in control groups in brief intervention studies: systematic review and meta-regression study

Reactivity to assessment has attracted recent attention in the brief alcohol intervention literature. This systematic review sought to examine the nature of change in alcohol consumption over time in control groups in brief intervention studies. Primary studies were identified from existing reviews published in English language, peer-reviewed journals between 1995 and 2005. Change in alcohol consumption and selected study-level characteristics for each primary study were extracted. Consumption change data were pooled in random effects models and meta-regression was used to explore predictors of change. Eleven review papers reported the results of 44 individual studies. Twenty-six of these studies provided data suitable for quantitative study. Extreme heterogeneity was identified and the extent of observed reduction in consumption over time was greater in studies undertaken in Anglophone countries, with single gender study participants, and without special targeting by age. Heterogeneity was reduced but was still substantial in a sub-set of 15 general population studies undertaken in English language countries. The actual content of the control group procedure itself was not predictive of reduction in drinking, nor were a range of other candidate variables including setting, the exclusion of dependent drinkers, the collection of a biological sample at follow-up, and duration of study. Further investigations may yield novel insights into the nature of behaviour change with potential to inform brief interventions design.

The international development of the ‘Social Norms’ approach to drug education and prevention

The social norms approach to health promotion has become remarkably popular in the last 20 years, particularly in the American college system. It is an alternative to traditional fear-based approaches of health education, which a growing body of research demonstrates is often ineffective in reducing alcohol and drug misuse. The social norms approach differs by recognizing that individuals, particularly young adults, tend to overestimate how heavily and frequently their peers consume alcohol, and that these perceptions lead them to drink more heavily themselves than they would otherwise do. Similar misperceptions have been found in a range of other health and non-health behaviours. The social norms approach aims to reduce these misperceptions, and thus personal consumption, through the use of media campaigns and personal feedback. Although the numbers of completed social norms projects outside the USA is small, the evidence from them is that the approach can be equally effective in both European and Australian contexts. It is also acknowledged that as an emergent field, there are limitations to the current social norms literature. There is a lack of randomized control trial studies, a lack of clarity of the role of referent groups and a need to better understand the processes through which misperceptions are transmitted. However, despite these issues, the social norms approach represents a new avenue for reducing alcohol and drug-related harm and is an area which merits further research.

A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students

BackgroundIncorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students.Methods/DesignAn online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site.DiscussionThis project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students.Final trial registration numberDRKS00004375 on the ‘German Clinical Trials Register’.

Binge drinking behaviour, attitudes and beliefs in a UK community sample: An analysis by gender, age and deprivation

Binge drinking has sparked considerable interest and concern. However, despite this interest little is known about the lay understanding of binge drinking and whether there are differences in understanding by gender, age and level of deprivation. Aims: This study investigated the beliefs and attitudes to binge drinking of a sample in the Inverclyde area. Methods: Using both cluster and quota sampling, 586 subjects completed a structured interview, using open questions about their beliefs on binge drinking and whether it was a problem generally and locally. Findings: Definitions of binge drinking tended to concentrate on intoxication and some described a dependent drinking pattern. Causes and solutions offered were varied but pointed-up levels of deprivation in respect of jobs and entertainment. More subjects regarded binge drinking as a problem in society than locally, which is consistent with research suggesting that misperceptions of others’ drinking increases with social distance. Differences in beliefs were found by age and level of deprivation but not gender. It was marked that no subject offered the ‘official’ definition of bingeing or even an approximation of it. Conclusions: Further research is required if future mass-media campaigns and interventions are to be relevant to the population.

Outdoor music festivals: Cacophonous consumption or melodious moderation?

Large outdoor music festivals have emerged as part of a general expansion of licensed recreational activities, but in research terms they have been largely impenetrable due to commercial sensitivities. These sensitivities notwithstanding, the number and scale of such events necessitate a greater understanding of alcohol and drug use and the potential to promote normative protective behaviours in this context. This study examines self-reported alcohol and drug behaviours of 1589 attendees at a music festival in Scotland during the summer of 2008. Similarities between the outdoor rock music festivals and the dance club scene are considered alongside the challenges associated with risk reduction in these settings. Results show that alcohol was consumed by the majority of samples; however, negative consequences were reported by a minority of respondents, suggesting evidence of controlled hedonism within a situation traditionally associated with unrestrained excess. Similarly, the majority of samples did not use drugs. The majority also report a number of self-regulating protective behaviours suggesting that alcohol and drug use is contained within a developing social culture of ‘controlled intoxication’. Results further suggest that although music festivals are transitory events, there is a degree of consistency amongst attendees. Music festivals may therefore be atypical but potentially effective environments to increase protective behaviours using normative messaging and modern communications media. This study was resourced exclusively by local alcohol and drug partnerships.

Student estimations of peer alcohol consumption: Links between the Social Norms Approach and the Health Promoting University concept

Background: The Social Norms Approach, with its focus on positive behaviour and its consensus orientation, is a health promotion intervention of relevance to the context of a Health Promoting University. In particular, the approach could assist with addressing excessive alcohol consumption. Aim: This article aims to discuss the link between the Social Norms Approach and the Health Promoting University, and analyse estimations of peer alcohol consumption among European university students. Methods: A total of 4392 students from universities in six European countries and Turkey were asked to report their own typical alcohol consumption per day and to estimate the same for their peers of same sex. Students were classified as accurate or inaccurate estimators of peer alcohol consumption. Socio-demographic factors and personal alcohol consumption were examined as predictors for an accurate estimation. Results: 72% of male and 51% of female students were identified as having accurate estimations about the amount of alcoholic drinks consumed per day by their peers. Male students, older students, those studying year 3 and above, and Turkish and Danish students were more likely to accurately estimate their peers’ alcohol consumption. Independent from these factors, students’ accurate estimation of peers’ drinking decreased significantly with increasing personal consumption. Conclusions: As accurate estimates of peer alcohol consumption appear to affect personal drinking behaviour positively, Social Norms interventions targeted at correcting possible misperceptions about peer alcohol use among students may be a useful health promotion tool in the context of a Health Promoting University.

A comparison of substance use behaviours and normative beliefs in North-West European university and college students

Abstract The social norms approach is an increasingly popular intervention for substance use that has been used extensively in the American college system. It operates by correcting normative misperceptions individuals hold about their peers. However, there have been few direct comparisons of substance use misperceptions between student populations in different European countries. The current study sought to address this through use of a survey of substance use and normative beliefs at universities in five European countries. Students at each site were invited to take part in an online survey that included items on personal substance use and the perceived use of peers. A total sample of 6404 students was obtained. Mann-Whitney and χ2 analysis were used to demonstrate an apparent misperception effect, with the majority of students at each site significantly (p<0.05) overestimating the substance use of their peers. This study suggests that students in Europe are prone to misperceiving the substance use of their peers in a manner similar to their American college counterparts, despite the cultural and legislative differences between these settings. This provides support for the potential in using social norms approaches to reduce rates of harmful substance use in European student populations.

A survey study on the associations between misperceptions on substance use by peers and health and academic outcomes in university students in North-West Europe

Abstract Introduction: The basis of Social Norms Theory is that behavior is influenced by the perception of peer behavior. This implies that an overestimation (misperception) of substance use by peers would lead to an increase in personal substance use. It is hypothesized that the misperception of substance use by peers is negatively associated with health and academic performance, and that this association can be explained by an increase in personal substance use. The aim of this study is to investigate the associations of misperception of consumption of tobacco, alcohol, and recreational drugs with health and academic performance, and to test whether or not this association could be explained by substance use in a sample of university students. Methods: Data of 6403 university students in five European countries were gathered through a questionnaire about substance use by themselves and by peers, physical and mental health, and academic functioning. Misperception is defined as an overestimation of the estimated prevalence of substance use among students. Multivariate models are built with misperception regarding tobacco, alcohol and recreational drugs, and personal use of substances as independent variables, and health and academic performance as dependent variables. Results: Misperception is significantly associated with health and academic functioning. This association could not be explained by personal substance use. Conclusions: This study subscribes to an earlier work on the importance of social norms, which indicates a negative influence of misperceptions on health and academic outcomes.

The Emerging Requirement for Digital Addiction Labels

[Context & motivation] Digital Addiction, e.g. to social networks sites and games, is becoming a public interest issue which has a variety of socio-economic effects. Recent studies have shown correlation between Digital Addiction and certain negative consequences such as depression, reduced creativity and productivity, lack of sleep and disconnection from reality. Other research showed that Digital Addiction has withdrawal symptoms similar to those found in drug, tobacco, and alcohol addiction. [Question/problem] While industries like tobacco and alcohol are required by certain laws to have a label to raise awareness of the potential consequences of the use, we still do not have the same for addictive software. [Principal ideas/results] In this study, we advocate the need for Digital Addiction labels as an emerging ethical and professional requirement. We investigate the design of such labels from a user’s perspective through an empirical study, following a mixed-methods approach, and report on the results. [Contribution] Our ultimate goal is to introduce the need for labelling to both researchers and developers and provide a checklist of questions to consider when handling this non-functional requirement.