tag:theconversation.com,2011:/global/topics/binge-drinking-1550/articlesBinge drinking – The Conversation2024-02-11T19:07:40Ztag:theconversation.com,2011:article/2230042024-02-11T19:07:40Z2024-02-11T19:07:40ZHILDA survey at a glance: 7 charts reveal we’re smoking less, taking more drugs and still binge drinking<p>Australians’ vices, including drinking, smoking and illicit drugs, have been revealed in the latest <a href="https://melbourneinstitute.unimelb.edu.au/hilda/publications/hilda-statistical-reports">HILDA survey</a>.</p>
<p>The <a href="https://melbourneinstitute.unimelb.edu.au/hilda">Household, Income and Labour Dynamics in Australia survey tracks</a> the same 17,000 Australians each year, with participants followed over the course of their lifetime. The survey collects information on many facets of life and is the only study of its kind in Australia.</p>
<h2>Smoking is declining, but young people are more likely to vape</h2>
<p>There has been substantial progress in reducing smoking rates since 2001, when 25% of males and 20% of females aged 15 and over reported being smokers. In 2021, these rates had dropped to 16% for males and 12% for females. This likely reflects the effects of tobacco control measures, as well as increased public awareness of the harmful health effects of smoking.</p>
<p>Declines have been biggest for young people, which reflects the fact that it is easier to prevent the take-up of smoking than it is to get smokers to quit. Indeed, HILDA shows that over 60% of people who quit smoking take it up again within three years.</p>
<p><iframe id="QZYJ2" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/QZYJ2/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>The progress on reducing smoking appears to have been somewhat offset by the rise in vaping or using e-cigarettes. In 2021, 14.1% of people aged 15 and over reported having tried vaping, and 16% of these people vaped daily.</p>
<p>Vaping is very much a young person’s activity. It is most common among people aged 15 to 24, and also relatively common among people aged 25 to 29. Many people who report vaping also report being smokers.</p>
<p><iframe id="zHKVU" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/zHKVU/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<hr>
<h2>Binge drinking remains common, especially for young men</h2>
<p>Risky drinking, here defined as usually consuming five or more standard drinks on each occasion, is relatively common, applying to over 20% of males and about 10% of females who ever drink alcohol. </p>
<p>After rising slightly between 2003 and 2009, there has since been a small decline in this measure of risky drinking for males. There has been little change in this measure for females. </p>
<p>Another measure of risky drinking, presented in the figure, is “excessive binge drinking”, defined as drinking at least five (if female) or seven (if male) drinks per occasion at least twice per month. This measure of risky drinking is more prevalent, but it has declined for both males and females since 2007.</p>
<p><iframe id="hOh4n" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/hOh4n/2/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Risky drinking is most common among men aged 20 to 24, followed by men aged 25 to 29. However, for both males and females, <em>regular</em> (but not necessarily “risky”) consumption of alcohol (drinking on five or more days per week) is more common in older age groups, and highest among people aged 60 and over.</p>
<p><iframe id="ORe6u" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/ORe6u/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<hr>
<h2>30 to 34 year-olds had the largest increase in using drugs</h2>
<p>The HILDA survey shows use of illicit drugs, such as marijuana, methamphetamine and cocaine, increased between 2017 and 2021, with annual use increasing from 15.7% to 17.6% for males and from 8.6% to 11% for females.</p>
<p><iframe id="R1Byp" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/R1Byp/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>People aged 20 to 24 are the most likely to use illicit drugs, but the increase in use was greatest for people aged 30 to 34.</p>
<p><iframe id="fTNBL" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/fTNBL/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>The use of multiple types of illicit drugs, known as polydrug use, is common for users of methamphetamine, cocaine and ecstasy, but much less common for users of marijuana.</p>
<p><iframe id="sUmMT" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/sUmMT/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/hilda-data-show-womens-job-prospects-improving-relative-to-mens-and-the-covid-changes-might-have-helped-222897">HILDA data show women's job prospects improving relative to men's, and the COVID changes might have helped</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/223004/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Roger Wilkins receives funding from the Australian Research Council.</span></em></p>Some 17,000 people told us exactly how much they drank, smoked and used illicit drugs. Here’s a unique snapshot of Australians’ vices.Roger Wilkins, Professorial Fellow and Deputy Director (Research), HILDA Survey, Melbourne Institute of Applied Economic and Social Research, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2075712023-06-28T20:47:28Z2023-06-28T20:47:28ZAdolescent drinking rates remain high in China despite ban<figure><img src="https://images.theconversation.com/files/533573/original/file-20230622-15-lpw9jw.jpg?ixlib=rb-1.1.0&rect=0%2C616%2C6237%2C3529&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Improved efforts are needed to prevent underage drinking and challenge lenient attitudes toward alcohol. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>There are plenty of health concerns for teens to worry about these days: the effects of <a href="https://theconversation.com/vaping-is-an-urgent-threat-to-public-health-112131">e-cigarette</a> and <a href="https://nida.nih.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders">cannabis use</a>, and how <a href="https://doi.org/10.1136/bmj.m4691">drinking could harm</a> their <a href="https://doi.org/10.1002%2Fwps.20786">developing brains</a>. </p>
<p>Although relatively more is known about youth drinking in the West, there is a significant knowledge gap when it comes to China, home to the world’s second-largest <a href="https://www.undp.org/china/youth">youth population</a>. </p>
<p>To learn more about how Chinese teens engage with alcohol, we conducted a systematic review of studies on teen drinking behaviours in China over a 30-year period from 1988 to 2018.</p>
<p><a href="https://doi.org/10.1016/j.ypmed.2023.107558">In our recently published study</a>, we found high levels of drinking among Chinese adolescents aged 12 to 17 years old. Around half of Chinese teens reported having consumed alcohol at some point. One in four reported drinking in the past month and one in 10 reported binge drinking. </p>
<p>These drinking rates, while significant, are in fact lower than those reported by <a href="https://www.emcdda.europa.eu/publications/joint-publications/espad-report-2019_en">European</a>, <a href="https://files.eric.ed.gov/fulltext/ED611736.pdf">American</a> and <a href="https://statistique.quebec.ca/en/fichier/enquete-quebecoise-tabac-alcool-drogue-jeu-eleves-secondaire-2019.pdf">Canadian</a> teens.</p>
<p>A second key finding is that teen drinking has not declined since <a href="http://www.chinadaily.com.cn/english/doc/2006-01/06/content_510002.htm">China set the legal drinking age at 18 years old</a> in 2006. This suggests that efforts to reduce underage drinking have not been as effective as intended.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="People clinking beer glasses" src="https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534697/original/file-20230628-21-8vvi61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Teen drinking has not declined since China set the legal drinking age at 18 years old in 2006.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Underage drinking</h2>
<p>People who start drinking younger are much more likely to develop <a href="https://doi.org/10.1111/j.1530-0277.2008.00806.x">alcohol-related</a> problems later in life. This means delaying the start of alcohol use should be a high priority for authorities. Drinking during adolescence, especially heavy drinking, can cause <a href="https://doi.org/10.1007/s11920-016-0689-y">functional and structural</a> brain changes that have long-term consequences for a person’s <a href="https://www.ncbi.nlm.nih.gov/books/NBK37610/">health and well-being</a>. Our analysis shows there is an urgent need for effective preventive measures to reduce underage drinking in China.</p>
<p>To examine drinking rates among Chinese teens, we reviewed all studies on teen drinking behaviours published in English and Chinese over the past three decades. We <a href="https://doi.org/10.1016/j.ypmed.2023.107558">identified</a> 186 relevant studies. Nine different measures of drinking were examined, such as lifetime drinking, past month drinking, past year drinking and binge drinking.</p>
<p>We found that around 25 per cent of Chinese teens reported drinking in the past month. This is close to the <a href="https://doi.org/10.1002%2Fwps.20786">worldwide average</a> for teens aged 15–19 years. However, it is lower than rates for European teens aged 15–16 years (48 per cent), American adolescents in grade 12 (29 per cent), and Québecois adolescents in grades 7 to 11 (32 per cent).</p>
<p>Another interesting finding was that Chinese male teens consistently reported higher rates of drinking than female teens. This pattern contrasts with trends observed in Europe and North America, where the gender gap in drinking behaviours has <a href="https://www.emcdda.europa.eu/publications/joint-publications/espad-report-2019_en">been narrowing</a>.</p>
<h2>Chinese teens still drinking</h2>
<p>We found no evidence that rates of teen drinking declined following China’s implementation of the ban on underage drinking. This contrasts with trends across 30 European countries, where the frequency of drinking among most teens has <a href="https://www.emcdda.europa.eu/publications/joint-publications/espad-report-2019_en">declined</a> over the past 25 years, though not when it comes to binge drinking.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man's hand refusing to take a glass." src="https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534694/original/file-20230628-21-ycyzl9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Tackling attitudes toward alcohol can help reduce drinking among teens.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Similar patterns have been observed in <a href="https://doi.org/10.9778%2Fcmajo.20150124">Canada</a>, where rates of binge drinking increased from 1996 to 2013, although no increase was observed for low-risk drinking behaviours. In the United States, <a href="https://files.eric.ed.gov/fulltext/ED615087.pdf">drinking</a> among eighth to 12th grade students, including binge drinking, has <a href="https://files.eric.ed.gov/fulltext/ED611736.pdf">declined</a> over the past three decades.</p>
<p>One important question is why the Chinese government’s approach has not succeeded when <a href="https://doi.org/10.1016/j.drugpo.2022.103606">similar policies in other countries have</a>. One possibility is weak or inconsistent enforcement of the underage drinking ban. This may have to do with cultural norms, which are <a href="https://doi.org/10.1111/j.1360-0443.2011.03514.x">more</a> <a href="https://doi.org/10.1093/alcalc/agg111">permissive</a> towards alcohol.</p>
<h2>Reducing teen drinking</h2>
<p>Prevention strategies that have proven effective in other countries should be adapted to the Chinese context. These could include <a href="https://doi.org/10.1016/j.drugalcdep.2018.05.031%22%22">family-</a> and <a href="https://doi.org/10.1542/peds.2007-2243E">school-based</a> <a href="https://doi.org/10.1016/j.jadohealth.2016.06.021">programs</a>, along with public education campaigns.</p>
<p>Although rates of drinking are lower among Chinese adolescents than in some western countries, they do not show the same downward trend. Further efforts to reduce teen drinking are therefore needed.</p>
<p>Stricter policy enforcement should come with additional measures to reduce easy <a href="https://doi.org/10.1016%2Fj.amepre.2009.11.005">access to alcohol</a>. Reshaping lenient cultural norms and attitudes towards underage alcohol as well as <a href="https://doi.org/10.1080/13669877.2013.788545">risk perception</a> towards alcohol is also important.</p>
<p>Drinking can offer some benefits and is often a basis for social <a href="https://theconversation.com/canadas-new-drinking-guidelines-dont-consider-the-social-benefits-of-alcohol-but-should-they-198379">connection</a>. Getting teens to delay drinking is arguably a more <a href="https://doi.org/10.1016/S0306-4603(02)00294-0">realistic</a> goal than advocating complete abstinence.</p>
<p>China has a large youth population and even small shifts in social policy and substance use norms could deliver large benefits for the health of individuals and society.</p><img src="https://counter.theconversation.com/content/207571/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Teen drinking has not declined in the years since China banned underage drinking. Better enforcement and changes in attitudes to alcohol are needed.Francis Vergunst, Associate Professor, Psychosocial Difficulties, University of OsloYao Zheng, Assistant Professor, Department of Psychology, University of AlbertaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2010412023-06-21T15:03:15Z2023-06-21T15:03:15ZWhy you’re more likely to drink when you’re happy than when you’re sad<figure><img src="https://images.theconversation.com/files/532693/original/file-20230619-23-wl2vw4.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5991%2C3997&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Contrary to popular belief, we may actually be more likely to drink in excess when we're happy.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-friends-having-fun-drinking-beer-2164874427">Lomb/ Shutterstock</a></span></figcaption></figure><p>There’s a long-held belief that people drink alcohol in excess to drown their sorrows. But <a href="https://psycnet.apa.org/fulltext/2023-79626-001.html">recent research</a> into mood and drinking has found the opposite is also true.</p>
<p>Using data from 69 studies (12,394 people in total) in the US, Canada, France and Australia, all of which employed surveys to assess mood and drinking levels, the researchers found no evidence that people drank more on days when they felt down. Rather surprisingly, however, people tended to drink – and drink heavily – on days when they were in a good mood. </p>
<p>The authors found that participants were between 6% and 28% more likely to drink on days they were in a good mood, and 17%-23% more likely to binge drink (having more than four or five drinks within a few hours) on these days.</p>
<p>These findings suggest that, contrary to popular belief, we may actually be more likely to drink in excess when we’re happy than when we’re feeling down. So, what explains this phenomenon? In <a href="https://www.sciencedirect.com/science/article/pii/S0306460314002688">our research</a>, we have identified several possible factors.</p>
<h2>‘Desire thinking’</h2>
<p>Drinking is associated with a thought process called “<a href="https://www.sciencedirect.com/science/article/pii/S0306460319303776">desire thinking</a>”. This is a way of thinking that’s geared towards anticipating positive outcomes from certain experiences, based on the associations we have with that experience.</p>
<p>Before we drink, we tend to have an expectation of it based on past experiences – such as how the alcohol will taste, the feeling of being intoxicated, or the idea that alcohol will make us more interesting. We may also have positive memories from other times we drank. If so, the next time we think about having a drink, we may immediately default to thinking of it in a positive light.</p>
<p>This can then lead to “<a href="https://www.sciencedirect.com/science/article/abs/pii/S0306460319303776">prolonged self-talk</a>”, where we remind ourselves of the reasons for drinking – such as because you did well at work, or because the weather’s nice. Both this and desire thinking can combine to maintain positive mood and expectations – intensifying the cravings for alcohol. </p>
<figure class="align-center ">
<img alt="A group of men cheers their pints of beer." src="https://images.theconversation.com/files/532695/original/file-20230619-27-6a5ys6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/532695/original/file-20230619-27-6a5ys6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532695/original/file-20230619-27-6a5ys6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532695/original/file-20230619-27-6a5ys6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532695/original/file-20230619-27-6a5ys6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532695/original/file-20230619-27-6a5ys6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532695/original/file-20230619-27-6a5ys6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Remembering positive experiences can intensify cravings.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/people-men-leisure-friendship-celebration-concept-464199170">Ground Picture/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Adding another layer of positivity to the mix, our research has also found that people tend to hold what we call positive “<a href="https://www.sciencedirect.com/science/article/pii/S0306460318303721">meta-cognitive beliefs</a>” regarding the usefulness of desire thinking.</p>
<p>In other words, when desire thinking makes us crave alcohol by reminding us of all the good things that come with drinking, we’re likely to trust that positive thought and see it as a good thing. Thinking positively about the positive experiences we’re about to have may increase our motivation to drink more.</p>
<p>The downside to this potent cocktail of positive thoughts and feelings is that it appears to be incredibly hard to control and resist. For example, there’s evidence that positive beliefs can make us feel like we’re <a href="https://www.cambridge.org/core/journals/european-psychiatry/article/abs/dysfunctional-metacognition-across-psychopathologies-a-metaanalytic-review/3EB4D6C4B21547750252ED1C85FD88A2">less in control of our thinking and behaviour</a>.</p>
<h2>Taking control</h2>
<p>In our clinical research with <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02619/full">addiction</a> and various <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02211/full">other mental health conditions</a>, we have found that being able to control the way we think about things – whether that thinking is positive or negative – is key to behavioural change and a balanced state of mind.</p>
<p>However, to take control of the way you think about something, you first need to become aware of your extended thought patterns. The better you become at “thinking about your thinking”, the easier it is to control both your positive and negative thoughts.</p>
<p>Let’s say this thought pops into your mind: “I am feeling good – I deserve to drink this weekend.” Instead of thinking more about this, choose to leave the thought alone – a technique called “<a href="https://link.springer.com/article/10.1007/s10942-005-0018-6">detached mindfulness</a>”. It’s also worth reminding yourself that it’s difficult to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306460314002329">stop craving something</a> if you think about it a lot.</p>
<p>Try to think of the positive and negative thoughts you have as similar to receiving a text message. We don’t always have control over whether the message we receive is good or bad, but we do have complete control over whether we choose to respond to it or not. This will help to show you that you have control over your desire thinking – and therefore your drinking choices.</p>
<p>Positive mood has also been implicated in other addictive behaviours, such as <a href="https://www.sciencedirect.com/science/article/pii/S0306460317302150">nicotine use</a>, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306460320307309">gambling</a>, and <a href="https://www.sciencedirect.com/science/article/pii/S0306460317300655">internet pornography addiction</a>. This tells us that positive mood may not be the pathway to a healthy body and mind, as we might believe. </p>
<p>Instead, what may be important is the ability to be flexible in the way we think and behave around positive and negative moods – and in particular, knowing that we can always make choices in how we behave, regardless of our patterns of thinking.</p><img src="https://counter.theconversation.com/content/201041/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The study found that people were more likely to binge drink on the days they were in a good mood.Robin Bailey, Reader in Psychology, Psychotherapy and Counselling, University of BoltonAdrian Wells, Professor of Clinical and Experimental Psychopathology, University of ManchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1981182023-04-13T15:17:09Z2023-04-13T15:17:09ZPlanning for a baby? Why both men and women should consider quitting alcohol before and during pregnancy<figure><img src="https://images.theconversation.com/files/520784/original/file-20230413-14-lfsl69.jpg?ixlib=rb-1.1.0&rect=65%2C57%2C5390%2C3571&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">You might want to make booze a thing of the past.</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/positive-multiethnic-couple-drinking-wine-with-guests-5876657/">pexels/monstera</a></span></figcaption></figure><p>When a couple is planning on having a baby, it’s often the woman who is seen as responsible for the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0749379716000660#bib8">health of the unborn child</a>. </p>
<p>In the UK, the chief medical officer’s <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf">drinking guidelines</a> recommend that women should abstain from alcohol consumption during pregnancy. This is because it’s known to increase the risk of <a href="https://pubmed.ncbi.nlm.nih.gov/31194258/">miscarriage</a> and <a href="https://www.nhs.uk/conditions/foetal-alcohol-spectrum-disorder/">foetal alcohol spectrum disorders</a> (FASD). </p>
<p><a href="https://theconversation.com/how-foetal-alcohol-spectrum-disorders-could-be-a-hidden-epidemic-52835">FASD</a> is an umbrella term used to describe a range of emotional, behavioural, developmental and learning challenges that are linked to a baby’s <a href="https://theconversation.com/up-to-17-of-children-in-the-uk-could-have-symptoms-of-foetal-alcohol-spectrum-disorder-according-to-latest-estimates-107649">exposure to alcohol</a> while in the womb.</p>
<p>The guidelines also recommend that if you’re planning to become pregnant, the safest approach is <a href="https://theconversation.com/health-risks-of-light-drinking-in-pregnancy-confirms-that-abstention-is-the-safest-approach-83753">not to drink</a> at all to minimise the risks to your pregnancy.</p>
<p>But evidence from large surveys shows that not all women stop drinking before pregnancy – whether the pregnancy was intended or not. In a 2017 <a href="https://pubmed.ncbi.nlm.nih.gov/28277356/">study</a> of 5,036 women in the US, the prevalence of alcohol consumption before pregnancy was similar between those with intended (55%) and unintended pregnancies (56%). </p>
<hr>
<figure class="align-right ">
<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><strong><em><a href="https://theconversation.com/five-important-things-you-should-have-learned-in-sex-ed-but-probably-didnt-202177">Five important things you should have learned in sex ed – but probably didn’t</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/mens-fertility-also-declines-with-age-heres-what-to-know-if-youre-planning-to-wait-to-have-kids-187498">Men’s fertility also declines with age — here’s what to know if you’re planning to wait to have kids</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/five-things-research-can-teach-us-about-having-better-sex-according-to-a-sex-therapist-199360">Five things research can teach us about having better sex, according to a sex therapist</a></em></strong></p>
<hr>
<p>In another 2015 <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.12816">study</a> of 3,390 Swedish women, weekly alcohol consumption was not significantly different between women with a “very planned pregnancy” (11%) compared with women with a “very unplanned pregnancy” (14%). </p>
<p>And a 2013 <a href="https://www.tandfonline.com/doi/full/10.3109/13625187.2013.851183">survey</a> of 258 Danish women found that although 77% of their pregnancies were “very” or “fairly well planned”, one out of five reported binge drinking early in the pregnancy. Among women with unplanned pregnancies, this rose to one out of three.</p>
<p>But while the focus tends to be on a woman’s relationship with alcohol before and during pregnancy, an increasing amount of evidence indicates that men’s alcohol use also <a href="https://www.sciencedirect.com/science/article/abs/pii/S0749379716000660#bib8">plays a role</a> when it comes to the health of the baby. </p>
<p>Indeed, alcohol can <a href="https://www.ajog.org/article/S0002-9378(08)02037-1/fulltext">affect sperm DNA</a>, in some cases reducing <a href="https://theconversation.com/how-mens-damaged-sperm-could-play-significant-role-in-recurrent-miscarriage-109683">fertility</a> and the potential to conceive. </p>
<h2>Why stop drinking?</h2>
<p>Better health outcomes for babies <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/729018/Making_the_case_for_preconception_care.pdf">begin before conception</a>, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293222/">clear links established</a> between the health of men and women before pregnancy and the health of their offspring. </p>
<p>Research shows that if couples are trying to conceive, it makes sense for them both to quit the booze <a href="https://edition.cnn.com/2019/10/03/health/dads-trying-to-conceive-stop-drinking-wellness/index.html">at least six months before pregnancy</a>. This helps to reduce the risk of potential negative outcomes for the baby such as <a href="https://journals.sagepub.com/doi/abs/10.1177/2047487319874530?journalCode=cprc">congenital heart disease</a>.</p>
<p>It also has <a href="https://www.drinkaware.co.uk/advice/how-to-reduce-your-drinking/the-benefits-of-drinking-less">benefits</a> for the <a href="https://www.drugsandalcohol.ie/32647/1/R-de-Visser-Dry-January-evaluation-2019.pdf">expectant parents</a>, such as better sleep quality, increased energy, and enhanced concentration levels.</p>
<p>Research has also <a href="https://www.sciencedirect.com/science/article/pii/S0749379716000660#bib8">found</a> that if a couple lives together and the male partner drinks, there is a higher chance that the woman will drink alcohol before and during the pregnancy.</p>
<p>One of the reasons why this might be the case is explored in <a href="https://journals.sagepub.com/doi/full/10.1177/1757975912441225">another study</a> where women said that drinking with a partner, whether before or during pregnancy, provided a sense of social connection.</p>
<figure class="align-center ">
<img alt="Pregnant woman holding belly." src="https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s best to avoid alcohol altogether if you are wanting to conceive.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/smiling-pregnant-woman-caressing-tummy-in-house-room-5427247/">Pexels/Amina Filkins</a></span>
</figcaption>
</figure>
<p>The period before pregnancy, known as preconception, is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975952/pdf/emss-77899.pdf">window of opportunity</a> for would-be parents to improve their health and increase their likelihood of conceiving. And <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/729018/Making_the_case_for_preconception_care.pdf">alcohol consumption</a> should be thought about as part of this. </p>
<p>As part of our recent research, we <a href="https://www.sciencedirect.com/science/article/pii/S2772653322000405?via=ihub">reviewed the literature</a> exploring people’s and health professionals’ views about information and support for reducing drinking in the period before getting pregnant. </p>
<p>We found that women were aware that lifestyle factors such as smoking or drinking alcohol can affect their pregnancy and increase the risk of poor outcomes for the baby. But there was a notable lack of awareness of the importance of men reducing their alcohol consumption when planning for pregnancy, too. </p>
<p>Indeed, men <a href="https://www.jabfm.org/content/jabfp/26/2/196.full.pdf">don’t usually go to clinics</a> to get information about preconception health, as this is usually left to the woman. </p>
<h2>Quit together</h2>
<p>While there is some indication that men, as well as women, are open to changing their drinking behaviour when planning for pregnancy, our literature review found that <a href="https://www.sciencedirect.com/science/article/pii/S1877575617300940?via=ihub">very few studies</a> have explored men’s or partners’ views on preconception health.</p>
<p>And while there are promising results from interventions and approaches aimed at enhancing preconception health in men and women, such as <a href="https://www.sciencedirect.com/science/article/pii/S1877575617300940?via=ihub">alcohol screening</a> followed by counselling and health education on <a href="https://www.sciencedirect.com/science/article/pii/S1877575617300940?via=ihub">changing behaviour</a>, there’s still not enough emphasis placed on men’s health at the preconception stage. This needs to change because, as the research shows, a baby’s health is influenced by both mum and dad. </p>
<p>So if you are considering trying for a baby, now could be the time for both partners to set new goals and <a href="https://www.nhs.uk/pregnancy/keeping-well/drinking-alcohol-while-pregnant/">cut down on drinking</a> together. And if you’re concerned about the amount you drink, or are dependent on alcohol, you should get <a href="https://www.nhs.uk/conditions/alcohol-misuse/treatment/">professional advice and support</a> on cutting down safely.</p>
<hr>
<p><em><strong>Other Quarter Life articles you may be interested in:</strong></em></p>
<p><strong><em><a href="https://theconversation.com/ivf-add-ons-why-you-should-be-cautious-of-these-expensive-procedures-if-youre-trying-to-conceive-180198">IVF add-ons: why you should be cautious of these expensive procedures if you’re trying to conceive</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/anxiety-can-lead-to-erection-problems-in-young-men-but-reaching-for-viagra-isnt-always-the-solution-191980">Anxiety can lead to erection problems in young men – but reaching for Viagra isn’t always the solution</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/young-people-are-drinking-less-heres-an-alternative-to-try-on-your-next-night-out-197465">Young people are drinking less – here’s an alternative to try on your next night out</a></em></strong></p><img src="https://counter.theconversation.com/content/198118/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>We would like to thank Lisa Schölin, Queens Medical Research Institute, University of Edinburgh; Andrea Hilton, Department of Paramedical, Perioperative and Advanced Practice, University of Hull and Anand Ahankari, Faculty of Health and Medical Sciences, University of Surrey who are part of the research team and helped with writing and reviewing this article.</span></em></p><p class="fine-print"><em><span>Lesley Smith received funding from the National Institute of Health Research, The Institute of Alcohol Studies, the former Alcohol Research UK (now Alcohol Change UK) and The Joseph Rowntree Foundation for alcohol-related research. </span></em></p><p class="fine-print"><em><span>Jayne Walker does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Cutting down on alcohol consumption before pregnancy can benefit the health of both men, women and their baby.Lolita Alfred, Lecturer in Mental Health, School of Health and Psychological Sciences, City, University of LondonJayne Walker, Senior lecturer| Professional Lead. School of Paramedical, Peri-Operative and Advanced Practice. Faculty of Health Sciences., University of HullLesley Smith, Professor of Women's Public Health, Institute of Clinical and Applied Health Research, University of HullLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2021792023-04-03T18:57:51Z2023-04-03T18:57:51Z‘Drinking isn’t an option, it’s more of a requirement’: the reasons for high alcohol consumption among some student athletes<figure><img src="https://images.theconversation.com/files/518298/original/file-20230329-14-otx13b.jpg?ixlib=rb-1.1.0&rect=0%2C8%2C5619%2C3020&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/man-woman-cheering-plastic-cup-beer-2281216105">AstroStar/Shutterstock</a></span></figcaption></figure><p>Binge drinking is <a href="https://academic.oup.com/alcalc/article/49/6/604/2888151">commonplace</a> in university sport. Students who play sport drink more heavily and frequently than other students. <a href="https://www.tandfonline.com/doi/abs/10.3109/16066359.2012.727508">Research</a> that surveyed students in England found that 62% of student sportspeople reported drinking at least twice per week, compared with 43% of those who didn’t play sport. </p>
<p>The research also found that 54% who play sport reported drinking heavily – more than six units on one occasion – at least once a week. For the students who didn’t play sport, this figure was 34%.</p>
<p>Alcohol use is even greater for those who play team sports. The <a href="https://www.tandfonline.com/doi/abs/10.3109/16066359.2012.727508">same research</a> found that 58% of team sport players were drinking heavily at least once a week, compared to 47% for individual sport players. </p>
<p>My <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2023.2185281">recent research</a>, conducted with colleagues, was interested in finding out what was influencing the drinking habits of students who play sports. Over the course of a year, I spent time with a student rugby club and was given permission to be part of the group. </p>
<p>I attended matches, away games and social gatherings, and carried out interviews with players, coaching staff, committee members, supporters and senior student union staff. I gained a detailed understanding of the pressures sportspeople faced to drink alcohol. </p>
<p>Our <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2023.2185281">research</a> found that student sportspeople face numerous pressures to drink heavily and often. Some of these pressures come from inside the sporting environment – from traditions, expectations and teammates. What’s more, alcohol was easily available and promoted to the athletes. </p>
<h2>Under pressure</h2>
<p>Our <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2023.2185281">research</a> found heavy alcohol consumption was a tradition embedded within university rugby. Players were expected to drink alcohol following matches, and attending social events was obligatory. Those who didn’t drink as expected were punished with humiliating challenges and a lower social status. Ben, a student athlete, said: </p>
<blockquote>
<p>You always feel under pressure to go out for a drink. After rugby or after you’ve played a game. It’s more intimidating drinking with the rugby team than with anybody else and that’s just a fact. I have never been as scared as I was at the first rugby social here.</p>
</blockquote>
<p>These players faced negative pressures to drink heavily, with the fear of embarrassing challenges looming over them. </p>
<p>However, there were also benefits to be gained from drinking heavily and behaving notoriously. The athletes reported that those who stood out from the group were praised and rewarded with higher status within the group’s social hierarchy. One student athlete said: </p>
<blockquote>
<p>It is commonplace, normal to go to have a few post-match. You’ve also got award ceremonies and Christmas, Halloween parties… end of season parties. Usually you have to have a dirty pint [a beer with a mix of alcoholic drinks added] if you’ve scored a hat-trick or a try, or you are man of the match. It’s everyone trying to out-do each other and impress each other. </p>
</blockquote>
<p>There was an expectation among many of the players that to play rugby they also had to drink alcohol. This expectation was reinforced by several external pressures they faced. </p>
<h2>Culture of alcohol</h2>
<p>Alcohol was easily accessible, cheap and heavily promoted to athletes. Students told me that a nightclub provided funding to sports clubs on the condition that they held social events in the student union – with the expectation that student sportspeople would attend the nightclub afterwards.</p>
<p>Coaches accepted that the team drank heavily, and to some extent reinforced it – for instance by rewarding players with alcohol. This gives athletes <a href="https://www.routledge.com/Sport-and-Alcohol-An-ethical-perspective/Jones/p/book/9781138558724">mixed messages</a>. They are expected to behave responsibly but are also praised and rewarded with alcohol.</p>
<figure class="align-center ">
<img alt="Rugby players on field" src="https://images.theconversation.com/files/518302/original/file-20230329-2310-6ln8w5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/518302/original/file-20230329-2310-6ln8w5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/518302/original/file-20230329-2310-6ln8w5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/518302/original/file-20230329-2310-6ln8w5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/518302/original/file-20230329-2310-6ln8w5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/518302/original/file-20230329-2310-6ln8w5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/518302/original/file-20230329-2310-6ln8w5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There should be other ways to promote team cohesion.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/rugby-375907813">makieni/Shutterstock</a></span>
</figcaption>
</figure>
<p>Coaches could act as role models by encouraging, praising and rewarding more moderate drinking behaviours. Methods to build team cohesion and help athletes bond with each other which aren’t centred around heavy drinking would also help – such as team-building exercises, sports days, alcohol-free socials, quizzes and alcohol-free dinners. A coach said:</p>
<blockquote>
<p>I see alcohol, as one form, of a huge array of different things that you can use to generate a team culture.</p>
</blockquote>
<p>Senior athletes have a high level of influence over novices. Allowing those who support a more moderate drinking environment to have a leadership role could help support a more measured approach to alcohol over time. </p>
<p>To support sportspeople to drink less, the way alcohol is marketed and promoted to these groups needs to be challenged. Universities have a duty of care over students and using alcohol for commercial gain could be jeopardising this.</p><img src="https://counter.theconversation.com/content/202179/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marc Harris does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Students who play sport drink more heavily and frequently than other students.Marc Harris, Senior Researcher, Cardiff Metropolitan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1979492023-01-18T06:11:02Z2023-01-18T06:11:02ZStudent sport has a drinking problem – here’s what needs to be done to change it<figure><img src="https://images.theconversation.com/files/504670/original/file-20230116-26-bdbeoh.jpg?ixlib=rb-1.1.0&rect=88%2C73%2C4808%2C3479&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research used qualitative interviews to understand what was driving athletes to consume alcohol. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sport-people-leisure-friendship-entertainment-concept-1098505418">Shutterstock / Master1305</a></span></figcaption></figure><p>Sport is generally <a href="https://bjsm.bmj.com/content/49/7/434.short">considered</a> a <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">health-enhancing</a> lifestyle choice. It reduces depression, anxiety and emotional distress and improves self esteem.</p>
<p>Despite this, there is <a href="https://academic.oup.com/alcalc/article/49/6/604/2888151">strong evidence</a> that many athletes – particularly those at university – engage in harmful levels of alcohol use. <a href="https://s3.eu-west-2.amazonaws.com/files.alcoholchange.org.uk/documents/AERC_FinalReport_0074.pdf">Multiple</a> <a href="https://figshare.cardiffmet.ac.uk/articles/thesis/Alcohol_Use_by_Student_Athletes/16988473">studies</a> conducted across different UK universities over the past decade indicate that sport participation may be a risk factor for the development of alcohol use disorders.</p>
<p>Our new <a href="https://journals.sagepub.com/doi/full/10.1177/01937235221144432">research</a> used qualitative interviews to understand what was driving athletes to consume alcohol. Over the course of a season, we recruited male and female rugby union athletes to take part in semi-structured interviews.</p>
<p>During these in depth interviews, athletes discussed the reasons they consumed alcohol, how they felt this differed, or was similar, to their teammates and other students, if the reasons they drink had changed over time, if they felt their drinking was linked to their sport and what role alcohol played in their sport.</p>
<p>Past <a href="https://s3.eu-west-2.amazonaws.com/files.alcoholchange.org.uk/documents/AERC_FinalReport_0074.pdf">research</a> from Northumbria University showed that 85% of students who played team sports were classified as having an alcohol use disorder, with rugby, football and hockey players reporting the highest levels of drinking.</p>
<h2>What’s causing student athletes to drink heavily?</h2>
<p>Our <a href="https://journals.sagepub.com/doi/full/10.1177/01937235221144432">study</a> suggests this sport drinking culture is being driven by a social hierarchy and status-seeking behaviours. We found that experienced athletes feel that novices need to go through the same (often degrading) experiences they had.</p>
<p>Experienced players had control over other less experienced teammates and those lower in the social hierarchy were forced to binge drink because they were new to the culture.</p>
<p>Athletes explained that initiation ceremonies, nights out and away games were all opportunities for older players to display dominance over novices, with initiation ceremonies key to maintaining the social hierarchy.</p>
<figure class="align-center ">
<img alt="Hands hold glasses and cheers." src="https://images.theconversation.com/files/504677/original/file-20230116-12-3isry0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/504677/original/file-20230116-12-3isry0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/504677/original/file-20230116-12-3isry0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/504677/original/file-20230116-12-3isry0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/504677/original/file-20230116-12-3isry0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/504677/original/file-20230116-12-3isry0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/504677/original/file-20230116-12-3isry0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Nights out were one of the main sites for binge drinking.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-friends-drunk-beverage-beer-cocktails-532094914">Shutterstock / Pra Chid</a></span>
</figcaption>
</figure>
<p>Despite speaking negatively about the social hierarchy, those in subordinate positions saw positives in the process. They rationalised these practices as useful for helping them feel more comfortable around teammates, given they had a mutual experience of being humiliated.</p>
<blockquote>
<p>You don’t have to drink to play rugby but if you don’t want to drink you’ve got to really be ballsy. I’d be scared to say, “No, I’m not drinking,” to about 30 different third years shouting around you. It’s just what we’re told to do and you kind of have to follow otherwise it’s not going to put you in great stead for the rest of the year. – Harry</p>
</blockquote>
<p>The social hierarchy was underpinned by the status of certain players. This enabled them to coerce other – often more novice – teammates. There were social rewards to be gained from binge drinking and engaging in “notorious” or “stupid” behaviours (such as drinking “a whole bottle of wine through a fresh salmon head”).</p>
<h2>Drinking to navigate social hierarchies</h2>
<p>On one hand, alcohol use functioned to maintain social divisions and convey dominance. On the other, drinking provided the opportunity for players to negotiate their position and climb to a higher standing. Participating in drinking practices was key to each person’s position within the group.</p>
<figure class="align-center ">
<img alt="A young boy playing rugby in a black kit." src="https://images.theconversation.com/files/504680/original/file-20230116-26-jsz3ws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/504680/original/file-20230116-26-jsz3ws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/504680/original/file-20230116-26-jsz3ws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/504680/original/file-20230116-26-jsz3ws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/504680/original/file-20230116-26-jsz3ws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/504680/original/file-20230116-26-jsz3ws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/504680/original/file-20230116-26-jsz3ws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Alongside football and hockey, rugby players reported the highest levels of drinking.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/rugby-players-training-on-pitch-park-322664444">Shutterstock / wavebreakmedia</a></span>
</figcaption>
</figure>
<p>There was also a fear among players, particular younger athletes, that refusing to engage would leave them at the bottom of the heap. Players described a culture of fear where they were “scared to say no I’m not drinking”.</p>
<p>Novice athletes appeared to be engaging in the culture of intoxication for social survival, rather than personal choice. Athletes – and younger athletes in particular – feared opposing the pressure to consume alcohol.</p>
<blockquote>
<p>Essentially the people want a story to tell. They wanted to say, “We did this, and it was wild,” everyone wants that story. The people who set the initiation think, “Well, we had to do it, you aren’t getting off.” – James</p>
</blockquote>
<p>Complying with drinking rituals and traditions was perceived to be a show of strength. Those who demonstrated the most extreme behaviours were rewarded with elevated status and respect. There was also a need to ensure that everybody complied and nobody got off lightly.</p>
<p>Senior players who had already been on the receiving end of the humiliation developed a sense of injustice if others did not go through the same experience. Athletes used the fact that the power imbalance will soon shift in their favour to justify being on the receiving end of these rituals.</p>
<blockquote>
<p>Because we got given it, we had it done to us, so now they’ve got to be given it. They’ll be able to give it to someone next year. It’s like power over people. You wouldn’t have power over them in any other situation. – Rhys </p>
</blockquote>
<p>Novice athletes explained that the vision of them putting the pressure on others was enough to appease anxieties around currently bearing the brunt of the intimidation.</p>
<h2>What needs to be done to foster a healthier environment?</h2>
<p>Our <a href="https://journals.sagepub.com/doi/full/10.1177/01937235221144432">research</a> implies that to address the heavy drinking culture in university sports, new people with a more measured approach to alcohol need to be grown into positions of strength within the social hierarchy. This will involve giving players with more moderate drinking habits leadership opportunities within university teams.</p>
<p><a href="https://figshare.cardiffmet.ac.uk/articles/thesis/Alcohol_Use_by_Student_Athletes/16988473">Findings of the research</a> have suggested that universities need to advocate for a more moderate drinking culture and educate players on the harms of excessive drinking and its negative physiological and psychological impact on performance.</p>
<p>Alternative social activities also need to be introduced which <a href="https://journals.sagepub.com/doi/full/10.1177/01937235221144432">fulfil the need</a> to build team cohesion. This will help to change the values, norms and expectations within university sport and develop a culture with less reliance upon alcohol use and intoxication.</p><img src="https://counter.theconversation.com/content/197949/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marc Harris does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>New research suggests senior athletes use binge drinking culture to display dominance over novices.Marc Harris, Senior Researcher, Cardiff Metropolitan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1961062023-01-06T13:30:39Z2023-01-06T13:30:39ZAlcohol use is widely accepted in the US, but even moderate consumption is associated with many harmful effects<figure><img src="https://images.theconversation.com/files/501999/original/file-20221219-26-6hbnxe.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6720%2C4466&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research increasingly shows that the dangers of alcohol have been downplayed and its benefits exaggerated.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/an-elderly-man-abuses-alcohol-royalty-free-image/1175893790">Nes/E+ via Getty Images</a></span></figcaption></figure><p><a href="https://theconversation.com/el-consumo-de-alcohol-esta-ampliamente-aceptado-en-estados-unidos-pero-incluso-el-consumo-moderado-esta-asociado-a-numerosos-efectos-nocivos-201655">Leer en español.</a></p>
<p>This month, millions of Americans are taking part in “<a href="https://www.today.com/health/dry-january-what-it-what-are-benefits-women-t146331">Dry January</a>” in an effort to forgo alcohol for a month and cleanse themselves of the excesses of the holiday season.</p>
<p>Alcohol is the <a href="https://www.globaldrugsurvey.com/">most widely used drug</a> in the world, including in the U.S.</p>
<p>In 2020, nearly 70% of people ages 18 and older in the U.S. said they had consumed an alcoholic drink <a href="https://www.samhsa.gov/data/report/2020-nsduh-detailed-tables">in the previous year</a>, according to the National Survey on Drug Use and Health. Additionally, 24% of people reported binge drinking – defined for women as four or more drinks per occasion and five or more drinks per occasion for men – in the previous month. </p>
<p>The COVID-19 pandemic brought with it important changes in alcohol consumption. One nationally representative sample found that while the number of people who reported drinking in the past year remained consistent from 2019 to 2021, the number of people <a href="https://doi.org/10.1111/acer.14839">consuming alcohol every day increased from 6.3% to 9.6%</a>.</p>
<p>Partially because alcohol is such a commonly used substance, heavily marketed and glamorized in pop culture, Americans’ comfort with and acceptance of its use in everyday life is remarkably high. But should it be? </p>
<p><a href="https://www.sph.pitt.edu/directory/christina-mair">I research alcohol use</a> and the associations between drinking and a wide range of problems. While the <a href="https://www.cdc.gov/opioids/basics/epidemic.html">rising opioid epidemic</a> has received a lot of attention in recent years, the number of deaths attributable to alcohol each year is on par with the overall number of annual deaths from <a href="https://www.cdc.gov/nchs/products/databriefs/db457.htm">drug overdose</a>, with both increasing rapidly in the past few years. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/2v7W64rmtqQ?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Having even one drink a day can have a negative effect on your health.</span></figcaption>
</figure>
<h2>What about moderate drinking?</h2>
<p>In the past two decades, the idea that moderate drinking may actually confer health benefits <a href="https://doi.org/10.2337/diacare.28.3.719">has taken hold</a>, backed up by <a href="https://doi.org/10.1136/bmj.319.7224.1523">some preliminary and limited evidence</a>. This led to the broad notion <a href="http://www.health.com/health/article/0,,20410287,00.html">in the popular media</a> that a glass of red wine a day reduces the risk of cardiovascular disease and diabetes. </p>
<p>But there was one major flaw in many of the studies used to back up the claim that a glass of red wine is good for health. They compared those who drink at moderate levels to people who consume no alcohol whatsoever, rather than comparing those who drink heavily versus at lower levels. </p>
<p>There are many reasons why people who drink at moderate levels may be fundamentally different – and healthier – than those who do not drink at all. For example, many people who develop new illnesses unrelated to their alcohol use quit drinking, making the group of alcohol abstainers <a href="https://doi.org/10.1093/aje/kwn093">appear less healthy</a> than those who consume alcohol at low or moderate levels. </p>
<p>In 2018, the National Institutes of Health initiated a large randomized control trial – the gold standard for understanding causal relationships – to look into the <a href="https://www.nytimes.com/2017/07/03/well/eat/alcohol-national-institutes-of-health-clinical-trial.html">benefits of moderate drinking</a>.</p>
<p>That trial was designed to pick up the heart benefits of consuming one drink a day, but was not going to be able to detect the negative consequences of moderate alcohol use, such as <a href="https://www.nytimes.com/2018/06/18/health/nih-alcohol-study.html">increases in breast cancer</a>. Because of its inability to <a href="https://doi.org/10.1136/bmj.k3888">pick up on known alcohol-related harms</a> and concerns that the study was co-funded by the alcohol industry, the trial was <a href="https://clinicaltrials.gov/ct2/show/study/NCT03169530">halted after a few months</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/GySPkogSYLg?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A landmark 2022 study found that even low levels of alcohol consumption can be dangerous.</span></figcaption>
</figure>
<h2>Alcohol’s link to cancer and other harms</h2>
<p>Thanks to lobbying by <a href="https://doi.org/10.1111%2Fadd.13048">the powerful</a> <a href="https://doi.org/10.1371/journal.pone.0170366">alcohol industry</a>, alcohol’s dangers may be underplayed and its benefits exaggerated. There are many <a href="https://doi.org/10.1016/j.ypmed.2003.11.027">well-established problems with drinking even at moderate levels</a> that likely outweigh any potential benefits. </p>
<p>Alcohol is the <a href="https://doi.org/10.1001/jama.291.10.1238">third-leading cause of premature death</a> in the U.S. and one of the leading <a href="https://doi.org/10.3389/fpubh.2020.00279">modifiable causes of death worldwide</a>, while receiving some of the least media and policy attention. Worryingly, the number of deaths attributed to alcohol increased by 25% between 2019 and 2020 – a faster rate of increase than for the percentage increase in all deaths – 17% – in the <a href="https://doi.org/10.1001/jama.2022.4308">first year of the COVID-19 pandemic</a>. These rates increased most rapidly among people ages 25 to 44.</p>
<p>The lifetime prevalence of alcohol use disorder – defined as an impaired ability to stop or control alcohol use despite <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder">adverse social, occupational or health consequences</a> – is nearly 30%. In other words, nearly a third of the population has been severely impacted by their drinking at some point in their lifetime.</p>
<p>Alcohol use, even at low levels, is linked to a number of cancers, including <a href="https://doi.org/10.1001/jama.2011.1590">breast</a>, <a href="https://doi.org/10.1093/annonc/mds337">colorectal, liver and esophagus</a>. Alcohol contributes to approximately <a href="https://doi.org/10.1016/j.canep.2021.101893">75,000 cancer cases and 19,000 cancer deaths per year</a>. Furthermore, a recent study found that more than 50% of adults in the U.S. are unaware of the <a href="https://doi.org/10.1158/1055-9965.EPI-22-0420">cancer-related risks of alcohol consumption</a>.</p>
<p>Alcohol also causes a number of serious harms to others, many of them violence-related. These include increased <a href="https://doi.org/10.1016/j.chiabu.2014.03.011">risk of child maltreatment</a>, physical abuse, intimate partner violence, <a href="https://doi.org/10.15288%2Fjsas.2002.s14.118">sexual assaults</a> and <a href="https://doi.org/10.1111%2Fj.1530-0277.2009.00912.x">gun violence</a>. Alcohol-involved traffic fatalities in the U.S. – after several decades of decreasing – <a href="https://www.nhtsa.gov/risky-driving/drunk-driving#">ticked up by 14% to 11,654 in 2020</a>.</p>
<h2>Disparities in alcohol-related consequences</h2>
<p>The effects of alcohol are not felt equally by all: The most vulnerable among us suffer the greatest consequences. In the U.S., Black and Latino people who drink experience a greater number of social consequences from drinking than white people who drink, <a href="https://doi.org/10.1111%2Fj.1530-0277.2008.00880.x">particularly among groups who consume alcohol at low levels</a>. These consequences include arguments or fights, accidents and workplace, legal and health problems.</p>
<p>In addition, studies show that adolescents who report minority sexual orientation tend to <a href="https://doi.org/10.1001/archpedi.162.11.1071">start drinking at younger ages</a> and continue to <a href="https://doi.org/10.1016/j.amepre.2013.11.010">binge drink more frequently as adults</a>. These differences in alcohol-related problems at the same level of alcohol consumption contribute to disparities in many other health outcomes for these populations.</p>
<h2>Raising taxes and drinking age could offset harms</h2>
<p>There are a number of things the U.S. could do to reduce the burden of alcohol consumption through public policy. One proven effective policy includes increasing <a href="https://www.irs.gov/businesses/small-businesses-self-employed/excise-tax">alcohol excise taxes</a>, which are selective sales taxes on the purchase of alcohol. Other policies that have been shown to be effective include restrictions on the number of stores that sell alcohol, restrictions on <a href="https://doi.org/10.1016/j.amepre.2013.03.008">hours of sale</a> and <a href="https://doi.org/10.1162/REST_a_00615">increases in the minimum legal drinking age</a> from 18 to 21. While the current minimum drinking age in the U.S. is 21, prior to 1984 the minimum drinking age <a href="https://www.cdc.gov/alcohol/fact-sheets/minimum-legal-drinking-age.htm#">varied from state to state</a>, with some states allowing drinking as early as age 18.</p>
<p>While the alcohol industry often stands against many of these policies and regulations, they are relatively easy to implement. Despite this, in the U.S., alcohol control policies have been in decline over the past several decades, with many states moving to <a href="https://doi.org/10.1111/add.16003">privatize alcohol sales</a> – in direct opposition to what experts know can reduce alcohol-related harms. Privitization, which <a href="https://doi.org/10.1016/j.amepre.2012.01.002">removes state monopolies on alcohol sales</a>, greatly increases per capita alcohol sales and consumption.</p>
<p>Although alcohol plays a pivotal role in American culture, in my view the undisputed consequences of drinking make it unwise to recommend alcohol as a path to better health and well-being. As I see it, the small reductions in cardiovascular disease that are questionably linked to low levels of consumption are hardly offset by the sizable harms of alcohol on individual and population health.</p>
<p><em>This is an updated version of an article <a href="https://theconversation.com/alcohols-health-benefits-hard-to-prove-but-harms-are-easy-to-document-98813">originally published on July 9, 2018</a>.</em></p><img src="https://counter.theconversation.com/content/196106/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christina Mair receives funding from the National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism</span></em></p>The number of deaths related to alcohol use in the US grew by a staggering 25% between 2019 and 2020, the first year of the COVID-19 pandemic.Christina Mair, Associate Professor of Behavioral and Community Health Sciences, University of PittsburghLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1863962022-07-08T14:13:48Z2022-07-08T14:13:48ZTavern tragedy reinforces need to give priority to tackling underage drinking in South Africa<figure><img src="https://images.theconversation.com/files/472810/original/file-20220706-21-vu70kc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The cause of the deaths of 21 young people in a South African pub is still unclear.</span> <span class="attribution"><span class="source">STR/AFP via Getty Images</span></span></figcaption></figure><p>On 26 June 2022, <a href="https://www.dispatchlive.co.za/news/2022-07-02-full-coverage-of-the-enyobeni-tavern-tragedy/">21 young people died</a> at the Enyobeni tavern in East London, in South Africa’s Eastern Cape province. The incident refocused public attention on the safety of young people in the country. </p>
<p>The direct cause of the 21 deaths has not yet been determined. But questions are being asked about why children under the age of 18 were consuming alcohol in the tavern. </p>
<p>Questions about teenage alcohol consumption are particularly pertinent given how frequent alcohol use is among young people in South Africa and the considerable harm caused by underage drinking. <a href="https://www.wits.ac.za/media/wits-university/research/coe-human/documents/ChildGauge2019.pdf#page=216">One third</a> of the South African population is under the age of 18.</p>
<p>A 2011 <a href="https://repository.hsrc.ac.za/handle/20.500.11910/2487">national survey</a> of learners in grades 8 to 11 found that 37% of males and 28% of females reported drinking in the past 30 days. An alarming 30% of male and 20% of female learners reported binge drinking during the same period. A more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617861/">recent survey</a> in the Western Cape found that 5.6% of first-year university students reported an alcohol use disorder in the past 12 months.</p>
<p>The latest <a href="http://www.ci.uct.ac.za/sites/default/files/image_tool/images/367/Child_Gauge/2022/Child%20Gauge%202021_FINAL_screen.pdf">Child Gauge</a> report drew attention to a number of child and adolescent health issues. The publication gives an annual snapshot of the situation of children in South Africa. Some of the issues highlighted were the problems associated with underage drinking and the need for public and government action to safeguard young people. </p>
<p>Globally, alcohol is a <a href="https://www.sciencedirect.com/science/article/pii/S0140673612617668?via%3Dihub">leading risk factor</a> for death and disability among adolescents aged 15 to 19 years. South Africa is <a href="https://repository.hsrc.ac.za/handle/20.500.11910/2487">no exception</a>. Several factors shape the patterns of alcohol use. These include the accessibility and affordability of alcohol as well as indiscriminate marketing. This highlights the need for <a href="https://bmjopen.bmj.com/content/11/8/e052879">child-centred laws</a> that restrict access to alcohol, regulate marketing and establish minimum unit pricing.</p>
<h2>Drivers and impact</h2>
<p>Adolescent alcohol consumption is driven by <a href="https://www.sciencedirect.com/science/article/pii/S1353829211002097?via%3Dihub">several factors</a>. These include the availability of alcohol and social norms. The media also play an influential role in young people’s drinking habits. </p>
<p>Young people are prolific consumers of media. They are frequently exposed to alcohol advertising and marketing. This marketing encourages the consumption of alcohol. It also perpetuates the idea that drinking is safe and normal. </p>
<p>Adolescents are vulnerable to the harmful effects of <a href="https://www.jsad.com/doi/10.15288/jsads.2020.s19.42">alcohol advertising</a>. Research <a href="https://onlinelibrary.wiley.com/doi/10.1111/acer.13477">suggests</a> that they may be disproportionately exposed to marketing by alcohol producers. Exposure to alcohol marketing has been <a href="https://academic.oup.com/alcalc/article/44/3/229/178279">shown</a> to get young people to drink at younger ages and in greater quantities. Voluntary advertising industry guidelines and self-regulation are <a href="https://onlinelibrary.wiley.com/doi/10.1111/add.13410">not adequate</a> to protect young people. This highlights the importance of – and urgent need for – government oversight in this area.</p>
<p>Adolescent drinking has harmful direct and indirect <a href="https://doi.org/10.1016/j.pbb.2020.172906">consequences</a>. These include rape, interpersonal violence, absenteeism, school failure, unwanted pregnancies, sexually transmitted infections, and HIV transmission.</p>
<p>Adolescents with alcohol use problems often experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761811/">mental health problems</a>, including mood disorders, anxiety disorders, conduct disorders and suicidal behaviour. These can be both the consequence of and the cause of alcohol use.</p>
<p>Impulsivity and risk taking are hallmarks of adolescence. Alcohol use exacerbates impulsivity and impairs judgement, thus increasing risk-taking behaviour in adolescence and increasing the likelihood of adverse outcomes, including injury and death.</p>
<p>Crucially, alcohol has harmful effects on adolescent <a href="https://www.sciencedirect.com/science/article/pii/S0091305719306021?via%3Dihub">brain development</a>. It leads to changes in brain structure and function which affect cognitive functioning.</p>
<h2>Addressing the problem</h2>
<p>The South African government has attempted to address problems associated with underage drinking. In South Africa it is illegal for anyone under the age of 18 to purchase alcohol. The <a href="https://www.gov.za/documents/liquor-act#:%7E:text=to%20provide%20for%20essential%20national,provide%20for%20matters%20connected%20therewith.">National Liquor Act (2003)</a> also stipulates that no one may supply liquor to minors. </p>
<p>Government has proposed pieces of legislation aimed at banning the <a href="https://academic.oup.com/heapol/article/33/7/786/5042203">advertising of alcohol</a>, raising the legal drinking age, limiting <a href="https://www.gov.za/documents/liquor-amendment-bill-draft-30-sep-2016-0000">hours for alcohol sales</a>, and lowering the legal <a href="https://www.gov.za/sites/default/files/gcis_document/202006/b7-2020nationalroadtraffic.pdf">maximum alcohol limit for drivers</a>. </p>
<p>To date no legislation in these areas has been enacted by Parliament. Alcohol use among young people remains high, with resulting negative consequences. On 4 July 2022, in response to the Enyobeni tragedy, President Cyril Ramaphosa <a href="https://presidency.click.bulkmailapp.co.za/social/s_enc/Z11kyqMsg8xR_5f9DPy3LmFCZWL_c6DzaXk2XEncTKs">called</a> for a conversation on the problem of under-age drinking. This suggests there may be political will to follow through with the proposed legislative changes. </p>
<p>The president referred broadly to action needed in several areas: </p>
<ul>
<li><p>good parenting </p></li>
<li><p>strengthening families </p></li>
<li><p>addressing shortcomings in recreational facilities </p></li>
<li><p>better enforcement of liquor outlet regulations </p></li>
<li><p>greater community engagement and stopping people aiming to put profit before the lives of children. </p></li>
</ul>
<p>Progress on these proposed interventions would go a long way to reducing alcohol consumption by young people and the associated harms. </p>
<h2>Recommendations</h2>
<p>The president’s recommendations place the burden of care on families and communities. However, the government also has a responsibility to protect children from alcohol-related harm. </p>
<p>To have a more meaningful effect, we propose concrete action in the following areas: </p>
<ul>
<li><p>a ban of packaging that appeals to young people </p></li>
<li><p>an increase in excise taxes on products that appeal to young people, such as fruit-flavoured alcoholic drinks </p></li>
<li><p>a ban on free alcohol and other forms of heavy discounting of alcohol prices </p></li>
<li><p>a limit on young people’s exposure to alcohol marketing at points of sale, on billboards, at sporting events and in other media such as via the internet and social media </p></li>
<li><p>accrediting of school-based prevention programmes to improve the quality of such programmes </p></li>
<li><p>ensuring that there are appropriate and high-quality treatment programmes available for young people </p></li>
<li><p>increased inspections of liquor outlets to ensure compliance with licensing regulations</p></li>
<li><p>mandatory verification of age for people buying alcohol via home delivery </p></li>
<li><p>a graduated driver’s licensing system whereby drivers aged 18 to 21 years are not permitted to test positive for any alcohol when driving. </p></li>
</ul>
<p>Our recommendations are in line with the World Health Organization’s <a href="https://www.who.int/initiatives/SAFER">SAFER initiative</a> as well as the <a href="https://www.who.int/teams/mental-health-and-substance-use/alcohol-drugs-and-addictive-behaviours/alcohol/our-activities/towards-and-action-plan-on-alcohol">Global Alcohol Action Plan</a> which was unanimously adopted by member states – including South Africa – at the World Health Assembly in May 2022. </p>
<p><em>Jason Bantjes and Charles Parry are contributors to the latest issue of the <a href="http://www.ci.uct.ac.za/sites/default/files/image_tool/images/367/Child_Gauge/2022/Child%20Gauge%202021_FINAL_screen.pdf">South African Child Gauge</a>, which focuses on child and adolescent mental health, including the problems associated with underage drinking in South Africa and the need for public and government action to safeguard young people.</em></p><img src="https://counter.theconversation.com/content/186396/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Adolescent alcohol consumption is driven by several factors such as the availability of alcohol and social norms.Charles Parry, Director, Alcohol, Tobacco & Other Drug Research Unit, SAMRC, South African Medical Research CouncilJason Bantjes, Chief Specialist Scientist in Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research CouncilLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1722252021-12-23T20:51:52Z2021-12-23T20:51:52ZWhy are young people drinking less than their parents’ generation did?<figure><img src="https://images.theconversation.com/files/436296/original/file-20211208-133881-17hyvka.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>As we head towards the end of the year, office get-togethers, Christmas lunches and New Year’s parties are upon us. It seems like a prime opportunity for young people to be drinking the night away.</p>
<p>But something unexpected has happened since the start of this century. Young people in Australia, the UK, Nordic countries and North America have, on average, been <a href="https://academic.oup.com/eurpub/article/31/2/424/5981990?login=true">drinking significantly less alcohol</a> than their parents’ generation did when they were a similar age.</p>
<p>During COVID lockdowns, some surveys indicate <a href="https://theconversation.com/forget-the-stereotypes-our-survey-shows-many-young-people-are-drinking-less-alcohol-in-lockdown-145832">this fell even further</a>.</p>
<p>Our research suggests this is <a href="https://www.jsad.com/doi/full/10.15288/jsad.2021.82.76">unlikely to be due simply to government efforts</a> to cut youth drinking. Wider <a href="https://academic.oup.com/eurpub/article/31/2/424/5981990?login=true">social, cultural</a>, technological and <a href="http://eprints.lse.ac.uk/103847/1/politicsandpolicy_young_people_and_the_post_crisis.pdf">economic changes</a> seem to be key to these declines. </p>
<p>Researchers conducting interview-based studies with young people in a range of countries have identified four main reasons for declining youth drinking.</p>
<p>These are: uncertainty and worry about the future, concern about health, changes to technology and leisure, and shifting relationships with parents.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/forget-the-stereotypes-our-survey-shows-many-young-people-are-drinking-less-alcohol-in-lockdown-145832">Forget the stereotypes. Our survey shows many young people are drinking less alcohol in lockdown</a>
</strong>
</em>
</p>
<hr>
<h2>Uncertain futures</h2>
<p>What it’s like to be young in developed countries is very different today than it was for previous generations. From <a href="https://theconversation.com/ten-years-to-1-5-c-how-climate-anxiety-is-affecting-young-people-around-the-world-podcast-171566">climate change</a> to planning a career and being able to afford a house, young people are aware their futures are uncertain.</p>
<p>Pressures to perform academically are starting earlier and <a href="https://theconversation.com/youth-anxiety-and-depression-are-at-record-levels-mental-health-hubs-could-be-the-answer-154722">rates of mental ill health are on the rise</a>.</p>
<p>Many young people are thinking about the future in ways previous generations didn’t need to. They are trying to gain a sense of control over their lives and secure the futures they aspire to. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/youth-anxiety-and-depression-are-at-record-levels-mental-health-hubs-could-be-the-answer-154722">Youth anxiety and depression are at record levels. Mental health hubs could be the answer</a>
</strong>
</em>
</p>
<hr>
<p>A couple of decades ago, getting really drunk was widely regarded by many young people as a “rite of passage” into adulthood and a good way of taking time out from the <a href="https://journals.sagepub.com/doi/abs/10.1177/1741659005057641">routines of work and study</a>.</p>
<p>Now, young people feel pressure to present as responsible and independent at an earlier age and some fear drinking to intoxication, and the loss of control it entails, will <a href="https://www.sciencedirect.com/science/article/pii/S0955395918303025">jeopardise their plans for the future</a>.</p>
<p>This emphasis on the future means young people <a href="https://journals.sagepub.com/doi/full/10.1177/00380385211008370">limit how much time they spend partying and drinking</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1462615200331227141"}"></div></p>
<h2>Young people are health conscious</h2>
<p>Health and well-being also seem to be increasingly important to young people.</p>
<p><a href="https://journals.sagepub.com/doi/abs/10.1177/0264550504048220">Research</a> from 15-20 years ago found young people viewed the consequences of heavy drinking (vomiting, unconsciousness) positively, or at least ambivalently.</p>
<p>More recent studies suggest this has <a href="https://www.sciencedirect.com/science/article/pii/S0955395917303250">changed</a>, with young people <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.13237">expressing concerns about risks to mental health</a> and long-term physical health related to their alcohol use.</p>
<p>However, <a href="https://pubmed.ncbi.nlm.nih.gov/33635553/">Australian</a> and <a href="https://www.sciencedirect.com/science/article/pii/S0955395920301663">Swedish</a> research also found some young people regard the social benefits of drinking as important to their well-being.</p>
<p>For many young people, however, this seems to involve moderate alcohol consumption, in place of the “<a href="https://www.sciencedirect.com/science/article/pii/S0955395906000910">determined drunkenness</a>” observed in the 1990s and early 2000s.</p>
<h2>What if my employer sees that?</h2>
<p>Technology has reshaped how young people socialise, with contradictory effects on youth drinking.</p>
<p>Social media provides new (less regulated) avenues for alcohol companies to promote their products. Holding a drink is <em>de rigueur</em> for a photo on social media celebrating a night out.</p>
<p>Yet, young people are also <a href="https://www.sciencedirect.com/science/article/pii/S0955395918301117">careful to manage their online images</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"601250131518877696"}"></div></p>
<p>Our research found young people worry about who might see images of them <a href="https://www.tandfonline.com/doi/full/10.1080/13676261.2020.1778658">drunk on social media</a> (such as friends, family and future employers), a risk that is unique to this generation. </p>
<p>The internet exposes young people to a wider range of possibilities for their lives, including new perspectives from which to reflect on their drinking choices. </p>
<p>It also offers social alternatives that are less likely to involve drinking, including <a href="https://www.tandfonline.com/doi/full/10.1080/13676261.2020.1746757">video games and other digital media</a>. </p>
<h2>Changing family relationships</h2>
<p>Styles of raising teenagers and managing their introduction to alcohol have <a href="https://www.tandfonline.com/doi/full/10.1080/16066359.2019.1663831">evolved over a generation</a>.</p>
<p>Many parents monitor their children on a night out and appear to oversee their drinking more closely than in previous generations, which is enabled by the mobile phones most young people in high-income countries now possess.</p>
<p>Young people also spend more time with their parents, potentially <a href="https://www.sciencedirect.com/science/article/pii/S0955395918303025">developing more communicative relationships</a> that reduce their need to drink and rebel.</p>
<h2>Binge drinking not as ‘cool’ anymore</h2>
<p>There are also a host of other reasons why young people limit alcohol consumption, including culture and religious affiliations, health conditions and personal motivations.</p>
<p>Altogether, these changes mean many young people do not regard heavy intoxication as “cool” and no longer see it as a <a href="https://www.sciencedirect.com/science/article/pii/S0955395918303025">key marker of independence and adulthood</a>.</p>
<p>Alcohol abstinence has become more <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.15611">socially accepted among young people</a>, along with choosing to consume alcohol moderately.</p>
<figure class="align-center ">
<img alt="Two people cheersing glasses of water with lemon" src="https://images.theconversation.com/files/436603/original/file-20211209-172173-1snq2gt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436603/original/file-20211209-172173-1snq2gt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436603/original/file-20211209-172173-1snq2gt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436603/original/file-20211209-172173-1snq2gt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436603/original/file-20211209-172173-1snq2gt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436603/original/file-20211209-172173-1snq2gt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436603/original/file-20211209-172173-1snq2gt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Drinking less, or not at all, is more accepted by young people today than it used to be.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>These factors play out differently for young men and women. Some research points to loosening of gendered expectations of drinking, with new opportunities for men to demonstrate masculinity <a href="https://www.sciencedirect.com/science/article/pii/S0955395918303025">without drinking heavily</a>.</p>
<p>Yet, differences remain in how young men and women use alcohol, with women having to navigate a range of gendered risks (such as unwanted sexual attention) and being judged more harshly when they are seen to be drunk (<a href="https://journals.sagepub.com/doi/10.1177/2056305116628889">including online</a>).</p>
<p>Of course, some young people continue to drink a lot and there will always be blips in alcohol use around holidays such as Christmas and New Year’s Eve.</p>
<p>But whether alcohol consumption among young people continues its overall decline may have more to do with the wider contexts of their lives than the sometimes <a href="https://oxford.universitypressscholarship.com/view/10.1093/acprof:oso/9780199551149.001.0001/acprof-9780199551149">poorly selected policies their governments implement</a>.</p><img src="https://counter.theconversation.com/content/172225/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah J MacLean receives funding from the Australian Research Council and the Victorian Responsible Gambling Foundation. In the past she has also received funding from the National Health and Medical Research Council, the Victorian Health Promotion Foundation, the Foundation for Alcohol Research and Education and the National Drug Law Enforcement Research Fund</span></em></p><p class="fine-print"><em><span>Amy Pennay has received funding from the Australian Research Council, the National Health and Medical Research Council, Beyond Blue, the National Drug Law Enforcement Research Fund, the Victorian Health Promotion Foundation, the Victorian Responsible Gambling Foundation, the Foundation for Alcohol Research and Education, and various state and local governments.</span></em></p><p class="fine-print"><em><span>Gabriel Caluzzi has received funding from the Australian Research Council and the Foundation for Alcohol Research and Education.</span></em></p><p class="fine-print"><em><span>John Holmes receives funding from the Wellcome Trust (208090/Z/17/Z), the National Institute for Health Research, Economic and Social Research Council, UK Prevention Partnership, Cancer Research UK, other Government bodies and third sector organisations working to improve public health. </span></em></p><p class="fine-print"><em><span>Jukka Törrönen has received and receives funding from the Swedish Research Council for Health, Working Life and Welfare, under Grants no. 2016-00313 and 2020- 00457.</span></em></p>Researchers have identified four main reasons young people in high-income countries are drinking less.Sarah J MacLean, Associate professor, La Trobe UniversityAmy Pennay, Research Fellow, La Trobe UniversityGabriel Caluzzi, Postdoctoral Research Officer, La Trobe UniversityJohn Holmes, Professor of Alcohol Policy, Sheffield Alcohol Research Group, University of SheffieldJukka Törrönen, Professor, The Centre for Social Research on Alcohol and Drugs, Stockholm UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1653602021-08-23T18:46:26Z2021-08-23T18:46:26ZUniversities need to prepare for student binge drinking after COVID-19 shutdowns<figure><img src="https://images.theconversation.com/files/417073/original/file-20210819-27-1w32dr8.jpg?ixlib=rb-1.1.0&rect=38%2C68%2C5042%2C2825&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Students headed to university are thirsty for socializing and missed milestones, and risky alcohol consumption could be more of a problem than it usually is. </span> <span class="attribution"><span class="source">(AP Photo/Kathy Willens) </span></span></figcaption></figure><p>This fall, students headed to university campuses aren’t only dealing with the usual transitions. Students are facing unique transitions to post-secondary life because of the COVID-19 pandemic. </p>
<p>Both new and returning university students are preparing to study in-person for the first time since the pandemic began. Some may be looking for <a href="https://ottawa.ctvnews.ca/pop-up-covid-19-vaccine-clinic-for-post-secondary-students-launches-tuesday-1.5531922">clinics to get vaccinated</a>. </p>
<p>At some schools, there are <a href="https://www.cbc.ca/news/canada/university-students-residence-spaces-1.6111147">fewer spaces in residence due to social distancing policies and more competition for those spots</a> from students who deferred admission and those coming from Grade 12.</p>
<p>These transitions — coupled with usual student patterns of socializing and using substances — may challenge students, institutions and campus communities. </p>
<h2>Period of experimentation</h2>
<p>The shift from secondary to post-secondary life is one of the <a href="https://doi.org/10.1177/0022146517693050">densest periods of transition</a> in a <a href="https://doi.org/10.1111/acer.13164">person’s life</a> — a time when multiple changes happen simultaneously. </p>
<p>It is a period of experimentation and exploration where students try new things as they progress towards adulthood. For many students this will be the first time they <a href="https://doi.org/10.1177/0022042617699195">consume or regularly use alcohol and other drugs</a>. </p>
<p>Among different age and demographic cohorts in Canada, binge-drinking rates are <a href="https://health-infobase.canada.ca/alcohol/cpads/">most prevalent</a> among post-secondary students. Research indicates that in the United States, <a href="https://searchworks.stanford.edu/view/7822928">nearly 40 per cent of post-secondary students</a> have engaged in binge drinking. Some research suggests that between <a href="https://pubmed.ncbi.nlm.nih.gov/28526355">2001 and 2013 there was a significant increase of binge drinking</a> among adults aged 18 and older in the U.S. </p>
<h2>Double cohort</h2>
<p>Some early signs suggest <a href="https://www.universityaffairs.ca/news/news-article/universities-seeing-influx-of-applications-for-september">applications to universities for this fall have increased across the country</a>. But regardless of how many new applicants enter universities this year, there <a href="https://heqco.ca/david-trick-finding-precedents-for-the-unprecedented-part-1-a-new-double-cohort">will be an increase in the number of students transitioning to post-secondary education in Canada</a>. That’s because, as Lynn Wells, interim president of Brock University, notes, “<a href="https://www.universityaffairs.ca/news/news-article/universities-seeing-influx-of-applications-for-september">last year’s first-year students didn’t really have the experience of being at university in its fullest sense</a>.” </p>
<p>Universities saw something similar in 2001 when Ontario stopped offering Grade 13, so high school graduates <a href="https://www.cbc.ca/news/canada/ontario-s-double-cohort-strains-resources-1.360698">from grades 12 and 13 entered post-secondary education simultaneously</a>, <a href="http://eduvation.ca/2020/03/covid-impacts2/#">forming a “double cohort.”</a> </p>
<p>Beyond increased competition for residence spaces or student housing, students transitioning to university straight from high school and students whose university attendance has been entirely virtual to date <a href="https://www.dal.ca/covid-19-information-and-updates/our-approach.html">would all benefit from basic campus orientation</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/417077/original/file-20210819-21-1ypkvz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/417077/original/file-20210819-21-1ypkvz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/417077/original/file-20210819-21-1ypkvz1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/417077/original/file-20210819-21-1ypkvz1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/417077/original/file-20210819-21-1ypkvz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/417077/original/file-20210819-21-1ypkvz1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/417077/original/file-20210819-21-1ypkvz1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Students fresh out of Grade 12 and those who spent first year entirely online will both be facing a basic orientation to campus life.</span>
<span class="attribution"><span class="source">(Lauren Witte/Fresh Take Florida via AP)</span></span>
</figcaption>
</figure>
<h2>Drinking behaviours and harms</h2>
<p>The harms associated with alcohol use, like death and serious injury, have been found to peak as people <a href="https://doi.org/10.1016/j.drugalcdep.2014.02.019">transition over the minimum legal drinking age</a>. </p>
<p>Drinking is a <a href="https://nyupress.org/9780814788325/getting-wasted/">behaviour learned</a> collectively and vicariously among peers via a highly social process where individuals experiment to find a level of consumption they’re <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375385/">comfortable with</a>. </p>
<p>The social functions associated with drinking are assumed to produce positive social benefits for those who participate, and to offset the negative effects of alcohol like hangovers, sickness or injuries. </p>
<p>The most common answer for why some Canadians reduced alcohol consumption during the pandemic was the <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/210304/dq210304a-eng.htm">decrease in available social opportunities</a>. Notably, Statistics Canada finds that the number of Canadians who increased alcohol consumption is similar to the number of those who decreased their consumption, and among those who drank more in the pandemic, stress and boredom played a role.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/university-student-mental-health-care-is-at-the-tipping-point-122743">University student mental health care is at the tipping point</a>
</strong>
</em>
</p>
<hr>
<h2>Large gatherings?</h2>
<p>We’ll likely see increased alcohol use among students this fall.</p>
<p>Some people have been willing to attend large gatherings like the Calgary Stampede and its <a href="https://globalnews.ca/news/8018158/covid-coronavirus-calgary-stampede-2021/">crowded party tents</a>. Some universities have moved <a href="https://www.thewhig.com/news/local-news/queens-university-reverses-decision-to-host-in-person-homecoming-2021">to cancel</a> homecoming, and <a href="https://westerngazette.ca/news/homecoming-2021-clouded-by-uncertainty/article_72d073a0-8c52-11eb-a6cf-37629b067deb.html">questions still loom</a> over what many schools will do. </p>
<p>Cancelling events may not be effective in mitigating raucous behaviour. Students often organize events regardless of a school’s desire to host them. This summer Queen’s University students hosted a <a href="https://www.thewhig.com/news/police-break-up-street-party-in-university-district-saturday-night">street party</a>, much to the chagrin of local residents. </p>
<figure class="align-center ">
<img alt="A police car passes a student house where people are drinking outside." src="https://images.theconversation.com/files/417079/original/file-20210819-15-ebs4oe.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/417079/original/file-20210819-15-ebs4oe.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/417079/original/file-20210819-15-ebs4oe.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/417079/original/file-20210819-15-ebs4oe.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/417079/original/file-20210819-15-ebs4oe.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/417079/original/file-20210819-15-ebs4oe.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/417079/original/file-20210819-15-ebs4oe.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Street parties are a concern in addition to large campus-sponsored events like homecoming.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Geoff Robins</span></span>
</figcaption>
</figure>
<h2>Navigating ‘party culture’</h2>
<p>The rapid transition that comes when students move into post-secondary study comes with a period where <a href="https://doi.org/10.1111/acer.12945">individuals meet and establish their new peer groups</a>. </p>
<p>Some people perceive alcohol as a perfect chemical facilitator associated with socializing when they are anxious about meeting new people. This year, students entering campus for the first time may feel added pressure or desire to seek the social gatherings they missed — to form bonds and make up for lost time. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-help-high-school-seniors-cope-with-milestones-missed-due-to-coronavirus-139147">How to help high school seniors cope with milestones missed due to coronavirus</a>
</strong>
</em>
</p>
<hr>
<p>Students returning to campus having had their first year cut short in 2020 will also find unique challenges. They may be the gatekeepers to the campuses’ “party culture,” having achieved this status as students who are familiar with popular culture images in the west of a “regular college experience” connected to <a href="https://psycnet.apa.org/record/2012-07987-013">mass alcohol consumption and partying</a>. </p>
<p>This group may also want to amplify what remaining opportunities they have to attend large drinking events as they prepare to transition out of university, promoting a stronger drinking culture as they leave. </p>
<h2>Boost student programming</h2>
<p>It will be important for university communities to discuss the risks associated with high-intensity drinking and the intersection of harms that can come from such behaviours like hangovers, injuries and poor academic performance. </p>
<p>Schools should look to boost programming for new students and provide opportunities for structured social activities to prevent risky alcohol consumption by students. Programming to keep students engaged like concerts, sports days and group excursions could serve to support students in a prolonged orientation experience.</p>
<p>Communities and local public health units should look to work with student groups to communicate accepted behaviours with regards to socializing to ease the transition back to campus for the well-being of all.</p><img src="https://counter.theconversation.com/content/165360/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Leo Erlikhman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Cancelling campus events won’t address the potential harms of binge drinking this fall. Universities must plan additional activities to curb risky alcohol use and promote student wellness.Leo Erlikhman, Affiliated researcher, School of Policy Studies, Queen's University, OntarioLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1613382021-06-06T12:15:29Z2021-06-06T12:15:29Z#WineMom: Humour and empowerment or binge drinking and mental health challenges?<figure><img src="https://images.theconversation.com/files/403634/original/file-20210531-20-v0h4jl.jpg?ixlib=rb-1.1.0&rect=53%2C0%2C6000%2C3988&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A wine mom is a mother who drinks wine to take the edge off daily tasks associated with motherhood.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>If you Google the term “wine mom,” you’ll find an array of comedic returns, including countless <a href="https://www.winemag.com/2021/03/23/wine-mom-phenomenon-memes/">memes</a> of celebrities like <a href="https://cdn2.justwineapp.com/assets/article/2018/02/dybtbjyupplokeyttyff.gif">Julia Louis-Dreyfus</a> maniacally waving a bottle of wine or <a href="https://imgix.bustle.com/uploads/image/2018/7/10/69e6513d-4dc8-4aa0-8579-d1339bdb0d27-screen-shot-2018-07-10-at-111051-am.png">Amy Schumer</a> drinking from an oversized glass, or numbered lists pointing to “<a href="https://justwineapp.com/article/this-is-why-a-mom-needs-wine">signs you might be a wine mom</a>.”</p>
<p>You’ll also find popular media articles highlighting that <a href="https://www.cbc.ca/radio/nowornever/think-before-you-drink-renegotiating-your-relationship-with-alcohol-1.5373065/why-this-former-wine-mom-is-calling-out-drinking-culture-1.5376932">while this trope initially appears to be harmless fun</a>, it also alludes to a <a href="https://www.washingtonpost.com/news/parenting/wp/2018/09/21/the-cheeky-wine-mom-trope-isnt-just-dumb-its-dangerous/">darker underside of modern motherhood</a>. </p>
<p>As <a href="https://canfasd.ca/topics/prevention/">fetal alcohol spectrum disorder (FASD) prevention</a> researchers, we are increasingly interested in the growing popularity of this phenomenon and its portrayal on social media. </p>
<p>A wine mom is a mother who drinks wine to take the edge off daily tasks associated with motherhood. While the use of substances to cope with challenges is not new (like “<a href="https://www.goretro.com/2014/08/mothers-little-helper-vintage-drug-ads.html">mother’s little helper</a>”), the term wine mom <a href="https://www.romper.com/p/a-short-history-of-the-wine-mom-meme-9709313">became popular in the mid-2010s</a> when mothers began to <a href="https://www.theatlantic.com/family/archive/2020/05/wine-moms-explained/612001/">self-identify and joke online</a> about drinking wine to cope with the stresses of modern motherhood. This self-identification helped women to <a href="https://doi.org/10.1080/10641734.2019.1659195">generate social connections</a> (though perhaps superficially) with other mothers in online spaces. </p>
<figure class="align-center ">
<img alt="Meme of woman pouring wine into measuring cup, caption reads 'when the laundry is piling up, there are dishes in the sink, kids are fighting and dinner isn't made but I'm like'" src="https://images.theconversation.com/files/403658/original/file-20210531-17-1rlys3h.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/403658/original/file-20210531-17-1rlys3h.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=558&fit=crop&dpr=1 600w, https://images.theconversation.com/files/403658/original/file-20210531-17-1rlys3h.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=558&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/403658/original/file-20210531-17-1rlys3h.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=558&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/403658/original/file-20210531-17-1rlys3h.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=701&fit=crop&dpr=1 754w, https://images.theconversation.com/files/403658/original/file-20210531-17-1rlys3h.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=701&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/403658/original/file-20210531-17-1rlys3h.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=701&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Women are described as ‘good mothers’ when they exhibit behaviours with being a doting caregiver.</span>
<span class="attribution"><span class="source">(MyKidsButler/Instagram)</span></span>
</figcaption>
</figure>
<h2>#WineMom fights back against the picture of a “good mother”</h2>
<p>What constitutes motherhood is a collection of behaviours and values that women embody, which are often influenced by social and cultural norms. </p>
<p>Women are described as “<a href="https://doi.org/10.1016/j.wsif.2016.09.004">good mothers</a>” when they exhibit behaviours associated with being a doting caregiver, having an immaculate home and engaging in flawless self-care. Women who fail to achieve these high standards run the risk of being characterized as “bad mothers” and being shamed or ostracized.</p>
<p>In our <a href="https://doi.org/10.1177/11782218211015195">recent study</a>, we explored posts using the <a href="https://www.instagram.com/explore/tags/winemom/">#winemom hashtag on Instagram</a> to better understand how alcohol consumption was juxtaposed with motherhood. </p>
<p>Consistent with what has been reported in popular media, we found that alcohol, and specifically wine, was often used to fight back against traditional social constructions of what it means to be a “good mother.” Women used the #winemom hashtag to convey that alcohol is an acceptable form of self-care and a means of coping with daily tasks. </p>
<h2>The darker side of #WineMom</h2>
<p>What we found concerning were the messages that normalized regular binge drinking and frequently used humour to express possible serious underlying mental health concerns. </p>
<p>Health critics have described alcohol as “<a href="https://doi.org/10.1111/j.1360-0443.2010.02945.x">no ordinary commodity</a>” given the serious biological, psychological and social impacts of its use. Growing evidence reveals <a href="https://www150.statcan.gc.ca/n1/pub/82-625-x/2017001/article/54861-eng.htm">that alcohol use amongst women of childbearing age in North America is increasing</a>. </p>
<p>This is where the #winemom hashtag can become problematic. </p>
<figure class="align-center ">
<img alt="Meme of woman sitting in bathtub with bottle of wine, caption reads: do you have plans for the weekend? Me:" src="https://images.theconversation.com/files/403659/original/file-20210531-13-1k6wq7z.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/403659/original/file-20210531-13-1k6wq7z.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=559&fit=crop&dpr=1 600w, https://images.theconversation.com/files/403659/original/file-20210531-13-1k6wq7z.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=559&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/403659/original/file-20210531-13-1k6wq7z.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=559&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/403659/original/file-20210531-13-1k6wq7z.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=702&fit=crop&dpr=1 754w, https://images.theconversation.com/files/403659/original/file-20210531-13-1k6wq7z.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=702&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/403659/original/file-20210531-13-1k6wq7z.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=702&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Women who are seeking ways to cope with additional stress may find shelter and connection within the virtual ‘wine mom’ community.</span>
<span class="attribution"><span class="source">(MyKidsButler/Instagram)</span></span>
</figcaption>
</figure>
<p>The hashtag was used as a form of <a href="https://doi.org/10.1177/1466138106067905">empowerment and connection</a> — but these messages normalize binge drinking and encourage the use of alcohol as a one-stop coping strategy. </p>
<p>Increasingly, in popular media former wine moms <a href="https://www.cbc.ca/radio/nowornever/think-before-you-drink-renegotiating-your-relationship-with-alcohol-1.5373065/why-this-former-wine-mom-is-calling-out-drinking-culture-1.5376932">are sharing their stories</a> of how participating in “wine mom” culture led them to develop a problematic relationship with alcohol. They’re now sharing posts <a href="https://abcnews.go.com/US/moms-journey-sobriety-peak-mommy-wine-culture/story?id=65412510">celebrating their sobriety</a> when they used to share memes about drinking. </p>
<h2>#WineMom and COVID-19</h2>
<p>COVID-19 prompted <a href="https://www.nbcnews.com/think/opinion/covid-19-drinking-spawns-new-mommy-juice-memes-truth-isn-ncna1239860">new versions of the “wine mom” meme</a>, centred on drinking to deal with the pandemic and its associated challenges. At the same time, researchers reported that <a href="https://www.ccsa.ca/sites/default/files/2020-04/CCSA-NANOS-Alcohol-Consumption-During-COVID-19-Report-2020-en.pdf">18 per cent of Canadians increased their alcohol use</a> during the pandemic to cope with lack of a regular schedule, boredom and stress.</p>
<p>As more research emerges on the impact of COVID-19, growing evidence speaks to the compounding impact of the pandemic on women and mothers. Mental health and substance use concerns have <a href="https://www.mentalhealthcommission.ca/sites/default/files/2021-05/mhcc_ccsa_covid_leger_poll_2_eng.pdf">remained very high</a>. Females reported the most mental health concerns, particularly among those living in households with young children (under 13). <a href="https://www.mentalhealthcommission.ca/sites/default/files/2021-05/mhcc_ccsa_covid_leger_poll_2_eng.pdf">Thirty-seven per cent of females</a> reported both moderate-to-severe anxiety and increased alcohol use. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/GPTKxV5_O1U?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Buzzfeed takes you through signs you are a wine mom, with their self-dubbed resident wine mom.</span></figcaption>
</figure>
<p>Women are being <a href="https://theconversation.com/the-moms-are-not-alright-how-coronavirus-pandemic-policies-penalize-mothers-144713">pushed out of the workforce</a> primarily due to child care obligations; COVID-19 restrictions are limiting opportunities for <a href="https://doi.org/10.1371/journal.pone.0245009">social connection</a>; and closures to <a href="https://www.cbc.ca/news/canada/kitchener-waterloo/gym-closure-water-pandemic-affecting-fitness-industry-1.6016420">gyms</a>, businesses and <a href="https://toronto.ctvnews.ca/lift-them-all-experts-join-chorus-demanding-ontario-let-people-enjoy-some-outdoor-activities-1.5409714">outdoor amenities</a> means reduced access to healthy outlets for stress. </p>
<p>Women who are seeking ways to cope with additional stress and increasing mental health challenges may find shelter and connection within the virtual ‘wine mom’ community.</p>
<h2>Women need support beyond wine mom culture</h2>
<p>What started out as a way for women to unite and poke fun at the challenges associated with motherhood has revealed an alarming indication that women’s needs are not being addressed in real and serious ways. The COVID-19 pandemic has further stressed mental health needs and highlighted how women are increasingly juggling multiple roles. </p>
<p>While #winemoms provides a space essential for empowerment and connection, we need to ensure that women have access to the <a href="https://bccewh.bc.ca/category/post/maternal-health-and-substance-use/">supports and resources</a> that provide healthier opportunities to cope with their stress and mental health challenges. It is evident that both during COVID-19 and beyond, women need support that extends beyond wine mom culture.</p><img src="https://counter.theconversation.com/content/161338/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kelly D. Harding works as a Research Associate for the Canada Fetal Alcohol Spectrum Disorder Research Network (CanFASD). Publication of the research discussed in this article was supported by CanFASD.</span></em></p><p class="fine-print"><em><span>Lisa Whittingham is supported in part by funding from the Social Sciences and Humanities Research Council.</span></em></p>The growing popularity of #winemom and its portrayal on social media. Is it humour and empowerment or binge drinking and mental health challenges?Kelly D. Harding, Adjunct Professor, Psychology, Laurentian UniversityLisa M Whittingham, PhD Candidate, Department of Child and Youth Studies, Brock UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1567712021-03-22T15:08:47Z2021-03-22T15:08:47ZWe tested claims that limiting alcohol advertising in South Africa would violate rights<figure><img src="https://images.theconversation.com/files/389275/original/file-20210312-23-1a134x6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In December 2020 South Africa announced a new ban on alcohol sales. </span> <span class="attribution"><span class="source">Phill Magakoe / AFP via Getty Images</span></span></figcaption></figure><p>The <a href="https://theconversation.com/lockdown-didnt-work-in-south-africa-why-it-shouldnt-happen-again-147682">lockdown restrictions</a> introduced in South Africa to curb the initial spread of COVID-19 in March 2020 were the tightest in the world. They included a <a href="https://www.ijhpm.com/article_3824_ef9b721113d3cf21cdf576351d99fad9.pdf">ban on alcohol</a> sales. This, the government said, was to <a href="https://theconversation.com/lockdown-didnt-work-in-south-africa-why-it-shouldnt-happen-again-147682">reduce the pressure on hospitals</a> caused by drinking-related trauma, and to discourage social gatherings. </p>
<p>This restriction exposed the huge public health and social impact of alcohol in South Africa. Dramatic decreases in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719204/">violence, injuries</a> and trauma-related hospital admissions were reported following the ban on alcohol sales. </p>
<p>The country has some of the <a href="https://businesstech.co.za/news/lifestyle/332909/south-africa-has-some-of-the-heaviest-drinkers-in-the-world/">heaviest drinkers</a> in the world. Excessive drinking is a major contributor to the <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1080-0">health burden</a>. Children are especially vulnerable. </p>
<p>In <a href="http://www.samj.org.za/index.php/samj/article/view/10944">South Africa</a> 12% of adolescents consumed their first alcoholic beverage before the age of 13 years. In 2016, of the young people between 15 and 19 years old who consumed alcohol, <a href="https://www.who.int/publications/i/item/9789241565639">65%</a> reported binge drinking. </p>
<p>Alcohol abuse is also linked to many societal problems. These include <a href="https://movendi.ngo/blog/2016/11/25/alcohol-related-domestic-violence-south-africa/#:%7E:text=Both%20alcohol%20abuse%20and%20intimate,health%20problems%20in%20South%20Africa.&text=67%25%20of%20domestic%20violence%20in,main%20risk%20factor%20for%20violence.">domestic violence</a>, <a href="https://mg.co.za/article/2017-10-27-00-effects-of-alcohol-consumption-in-south-africa-from-the-cradle-to-the-grave/">foetal alcohol syndrome</a>, <a href="https://www.research.ed.ac.uk/portal/files/50538790/e000573.full.pdf">child abuse</a>, <a href="https://www.tandfonline.com/doi/pdf/10.1080/10158782.2005.11441245">injuries</a>, and <a href="http://www.samj.org.za/index.php/samj/article/view/10944">risky sexual behaviours</a>.</p>
<p>In 2012, the South African government drafted the Control of Marketing of Alcoholic Beverages Bill. The Bill sought to restrict advertising, marketing, sponsorship, or promotion of alcoholic beverages except at the point of sale. It was drafted specifically to <a href="https://www.gov.za/statement-minister-social-development-ms-bathabile-dlamini-during-media-briefing-control-marketing#">protect children from alcohol advertising</a>. This intervention is consistent with <a href="https://apps.who.int/iris/bitstream/handle/10665/44395/9789241599931_eng.pdf;jsessionid=79070FC7C28ED77046F2D7FE044BEC62?sequence=1">World Health Organisation</a> recommendations to control alcohol-related harm.</p>
<p>The Bill underwent three regulatory and socio-economic impact assessments. It was meant to be published for public comment in 2013 but was never made public. Our previous <a href="https://academic.oup.com/heapol/article/33/7/786/5042203?login=true">research</a> found that the alcohol and allied industries lobbied heavily against the draft Bill.</p>
<p><a href="https://web.archive.org/web/20210311181315/https://www.freemarketfoundation.com/article-view/media-release-the-regulated-consumer-south-african-consumer-rights-under-threat">One argument</a> made by opponents to the draft Bill was that it would unjustifiably violate human rights. These include freedom of expression, and consumers’ rights to information. </p>
<p>In a <a href="https://periodicos.ufjf.br/index.php/HOMA/article/view/30678/21648">recent paper</a> we analysed these claims using the <a href="https://www.icj.org/wp-content/uploads/1984/07/Siracusa-principles-ICCPR-legal-submission-1985-eng.pdf">Siracusa Principles</a>, which guide the circumstances under which it is justifiable to restrict some rights. </p>
<p>Human rights are a well-recognised framework based on ethics and embedded in international law. They can be used to find a balance between competing societal goals. </p>
<h2>What does international human rights law say?</h2>
<p>The Siracusa Principles emerged from a meeting of experts in international law in 1984. They were concerned that limitations on rights in the International Covenant on Civil and Political Rights might be abused for national security or in a public emergency. They then provided principles for when limitations were permitted, according to international law.</p>
<p>The Siracusa Principles have <a href="https://www.who.int/hhr/information/25%20Questions%20and%20Answers%20on%20Health%20and%20Human%20Rights.pdf">five criteria</a> that should be met to permit a restriction on human rights. The restriction must be:</p>
<ul>
<li>provided for and carried out in accordance with the law;</li>
<li>in the interest of a legitimate objective of general interest;</li>
<li>strictly necessary in a democratic society to achieve the objective;</li>
<li>the least intrusive means available to reach the objective; and</li>
<li>not arbitrary or unreasonable.</li>
</ul>
<p>We used this framework in <a href="https://periodicos.ufjf.br/index.php/HOMA/article/view/30678/21648">our research</a> to answer the question: is restricting alcohol advertising, in the interest of public health, a justifiable limitation on the right to freedom of expression?</p>
<p>We concluded that restricting alcohol advertising to protect children’s rights and the right to health is justifiable, for several reasons. </p>
<p>Firstly, is it doubtful that corporations can claim human rights. Human rights are intended for natural persons and not legal entities like corporations. But even if rights apply to legal entities, it’s still possible that a limit on freedom of expression could be justified.</p>
<p>Secondly, public health reasons may be acceptable grounds for restricting freedom of expression according to the International Covenant on Civil and Political Rights. This is because there is strong evidence of the negative impact of alcohol consumption on children. And <a href="https://pubmed.ncbi.nlm.nih.gov/32079567/">alcohol advertising is linked to earlier initiation of drinking</a>. This suggests that South Africa’s draft Bill would be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5169036/">effective in reducing drinking in young people</a>.</p>
<p>Thirdly, many international human rights laws support this restriction. For example, <a href="https://www.refworld.org/docid/51ef9e134.html">article 24</a> of the United Nations Convention on the Rights of the Child supports children’s right to survival and development, and their right to health.</p>
<p><a href="https://www.refworld.org/docid/3ae6b38f0.html">Article 17(e)</a> of the Convention obliges governments to protect children from harmful information. Alcohol advertising would be information that is harmful for children.</p>
<p>Moreover, <a href="https://www.ohchr.org/documents/publications/handbookparliamentarians.pdf">article 12</a> of the International Covenant on Economic, Social and Cultural Rights obliges governments to protect people’s rights from violations by non-state actors – such as the alcohol industry. Government failure to regulate the activities of corporations that market harmful substances may amount to a violation of the <a href="https://www.refworld.org/pdfid/4538838d0.pdf">right to health</a>.</p>
<p>Lastly, there are no less intrusive and restrictive methods available other than restricting alcohol advertising. Given the scale of the problem, other kinds of interventions targeting high risk drinkers are either <a href="https://pubmed.ncbi.nlm.nih.gov/25495012/">ineffective</a> or pose insurmountable logistical challenges, such as the notion of identifying and targeting problem drinkers. </p>
<p>And <a href="https://pubmed.ncbi.nlm.nih.gov/27188534/">self-regulation does not work</a>. These industry-preferred interventions put the responsibility on individuals without recognising the responsibility of the alcohol industry in influencing drinking behaviours.</p>
<h2>Reducing harm</h2>
<p>Introducing regulation to reduce alcohol-related harm is fully consistent with human rights protection, particularly for children. Such regulation could include restricting alcohol advertising, marketing, sponsorship, or promotion.</p>
<p>The <a href="https://www.ohchr.org/en/hrbodies/hrc/wgtranscorp/pages/igwgontnc.aspx">international treaty on transnational corporations, business enterprises and human rights</a> is a new draft international law that could substantially strengthen public health goals. This treaty would place obligations on non-state actors, similar to those on governments, and help to make commercial actors accountable for their business practices.</p><img src="https://counter.theconversation.com/content/156771/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adam Bertscher receives scholarship funding from Bloomberg Philanthropies and University of Bath. He is affiliated with non profit organisations the Framework Convention on Global Health (FCGH) Alliance and the People's Health Movement. He has consulted for the Southern African Policy Alliance.</span></em></p><p class="fine-print"><em><span>Leslie London has received funding from the European Union Mission to South Africa, the International Development Research Centre, the South African Medical Research Council (MRC) and the South African National Research Foundation (NRF) both in the past and presently. In the past, he's received funding from the UK Medical Research Council and the US Centres for Diseases Control, the Western Cape Liquor Board and the DG Murray Trust. He is a member of the People health Movement, a participant in the C19 Peoples Coalition and has consulted to the Southern African Alcohol Policy Alliance. He has no involvement with any political party.</span></em></p>Opponents to South Africa’s Bill restricting alcohol advertising claimed it would unjustifiably violate human rights, such as freedom of expression, and consumers’ rights to information.Adam Bertscher, PhD candidate, University of BathLeslie London, Head of the Division of Public Health Medicine in the School of Public Health and Family Medicine, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1478492020-11-09T04:46:26Z2020-11-09T04:46:26ZBrutal rituals of hazing won’t go away — and unis are increasingly likely to be held responsible<figure><img src="https://images.theconversation.com/files/366621/original/file-20201030-24-1ovcjsn.jpg?ixlib=rb-1.1.0&rect=0%2C134%2C5405%2C3598&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/warning-sign-drunken-students-crossing-55008001">Shutterstock</a></span></figcaption></figure><p>Students enter university as young adults embarking on a new life. Hazing rituals are meant to be a lighthearted initiation into university life that breaks down barriers between seniors and freshers and prepares the newcomers for their future. But hazing can be a terrifying ordeal. </p>
<p>Many practices associated with being initiated by other students are <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3519607">cruel and inhumane</a>. Hazing has, in some cases, led to homicide, rape, sodomy, infliction of physical injuries, mental torture and forced binge drinking of alcohol. </p>
<p>Innocent lives are lost and student careers ruined. Many carry the mental scars of hazing for life. However, if they refuse to participate in hazing, they are <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3519607">ostracised</a>. </p>
<p>Internationally, courts are increasingly holding universities responsible for the impacts of hazing on their students. Unlike other countries, Australia lacks legislation that clearly makes universities and their colleges responsible for hazing. But the overseas experience shows legislation alone isn’t enough; cultural change is essential.</p>
<h2>How widespread is the problem?</h2>
<p>Hazing is culturally entrenched in Australian universities, especially in residential colleges. The 2018 privately commissioned <a href="https://apo.org.au/sites/default/files/resource-files/2018-02/apo-nid134766.pdf">The Red Zone Report: An investigation into sexual violence and hazing in Australian university residential colleges</a> describes hazing as “endemic”. Sydney University’s vice chancellor has confessed he is <a href="https://www.theguardian.com/australia-news/2018/feb/27/sydney-university-says-it-is-powerless-to-stop-violent-hazing-of-students">“powerless” to stop hazing</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/hazing-and-sexual-violence-in-australian-universities-we-need-to-address-mens-cultures-92685">Hazing and sexual violence in Australian universities: we need to address men's cultures</a>
</strong>
</em>
</p>
<hr>
<p>In 2017, 39 Australian universities had commissioned the Australian Human Rights Commission report <a href="https://humanrights.gov.au/our-work/sex-discrimination/publications/change-course-national-report-sexual-assault-and-sexual">Change the Course</a>. The report was scathing about the prevalence of hazing, sexual assault and harassment at university campuses and residential colleges. </p>
<p>Hazing poses a threat to international education in Australia, a <a href="https://minister.homeaffairs.gov.au/davidcoleman/Pages/sydney-institute-address.aspx">A$35 billion “export industry”</a> employing more than 200,000 Australians. It is just behind iron ore, coal and natural gas.</p>
<p>In the US, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3724697">55% of students</a> on university campuses face hazing. In India 60% of students at universities and professional institutions are victims of hazing. In 2018 reported incidents of hazing <a href="https://www.deccanherald.com/content/665449/india-sees-75-increase-ragging.html">increased by 75%</a> in India. </p>
<p>In Australia, <a href="https://humanrights.gov.au/our-work/sex-discrimination/publications/change-course-national-report-sexual-assault-and-sexual">as many as half</a> (51%) of all Australian university students were sexually harassed in 2016*, many as part of hazing rituals. Many are subjected to other indignities.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-hazing-continues-to-be-a-rite-of-passage-for-some-85705">Why hazing continues to be a rite of passage for some</a>
</strong>
</em>
</p>
<hr>
<h2>Universities can’t escape responsibility</h2>
<p>While the individual perpetrators of hazing are subject to criminal and civil sanctions, the reality is that it is up to institutions to deal with the problem. Australia does not have standalone hazing legislation that clearly makes this the responsibility of universities and/or their colleges. </p>
<p><a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3519607">Such legislation exists</a> in the US (in 44 out of 50 states) and India (in 14 out of 29 states). These laws provide for wrongdoers to be imprisoned or fined. However, criminal liability has failed to stem the tide of hazing. </p>
<p>Civil courts have sought to help. They have recognised the university’s responsibility to its students and awarded damages to them under tort law. The US courts began this trend by imposing a duty of care on universities that left them liable for failure to control hazing. </p>
<p>In <a href="https://www.courtlistener.com/opinion/2200392/mullins-v-pine-manor-college/">Mullins v Pine Manor College</a> it was held that the university controlled residential premises. Thus, it was liable for the rape of a campus resident that happened due to its failure to arrange adequate security. </p>
<p><a href="https://law.justia.com/cases/delaware/supreme-court/1991/594-a-2d-506-5.html">Furek v University of Delaware</a> resulted from a fraternity hazing ritual during which oven cleaner was poured on the plaintiff’s face and neck, burning and permanently scarring him. The court held the university liable as through its clearly pronounced policies it had assumed responsibility for controlling hazing. </p>
<p>A 2018 US case, <a href="https://law.justia.com/cases/california/supreme-court/2018/s230568.html">Regents of University of California v Superior Court</a>, produced the most expansive view on the university’s liability. The behaviour of a student who suffered from schizophrenia had become erratic. The university knew about his behaviour. This student attacked another student with a kitchen knife, who then sued the university. </p>
<p>The court held the university liable as there was “a special relationship” between a university and students, creating a duty to protect the latter. The Regents decision reflects the modern reality of how much control an institution exerts over students and how much they depend on the university for their safety. </p>
<p>In Australia, there have been calls for a statutory duty of care to be imposed on universities. The ACT Supreme Court recently reached the same conclusion. </p>
<p>In <a href="https://www.courts.act.gov.au/supreme/judgments/sma-v-john-xxiii-college-no-2">SMA v John XXIII College (No 2)</a>, the plaintiff had non-consensual sex with a fellow student following the hazing ritual of binge drinking on the college premises and outside. She sued an affiliate college of ANU. The defendant was held liable for breaching its duty of care to the plaintiff on the grounds it failed to:</p>
<ul>
<li><p>stop the hazing ritual of drinking</p></li>
<li><p>direct the students in an intoxicated state to leave the college</p></li>
<li><p>properly handle the student’s sexual harassment complaint. </p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-governments-should-be-cautious-about-criminalising-hazing-92665">Why governments should be cautious about criminalising hazing</a>
</strong>
</em>
</p>
<hr>
<h2>Cultural change is essential</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Cover of Change the Course report" src="https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=830&fit=crop&dpr=1 600w, https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=830&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=830&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1043&fit=crop&dpr=1 754w, https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1043&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/367642/original/file-20201105-23-ym7wr1.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1043&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Human Rights Commission’s Change the Course report emphasises the need for cultural change.</span>
<span class="attribution"><a class="source" href="https://humanrights.gov.au/our-work/sex-discrimination/publications/change-course-national-report-sexual-assault-and-sexual">AHRC</a></span>
</figcaption>
</figure>
<p>Universities are an ecosystem in which students prepare for their life ahead. Judicial decisions both in the US and Australia emphasise universities have assumed responsibility for student safety, and it is they who must control hazing. </p>
<p>Hazing has become a “pandemic”. An isolated civil suit by a student helps but does not go to the heart of the problem. </p>
<p>What is required is <a href="https://theconversation.com/hazing-and-sexual-violence-in-australian-universities-we-need-to-address-mens-cultures-92685">cultural change</a>. The institutions themselves must drive this change. </p>
<p>A failure to stop hazing damages an institution’s own students and tarnishes its image. Universities, members of civil society and political leaders need to get serious about tackling the evil of hazing. </p>
<hr>
<p><em>This article was co-authored by D.K. Srivastava — formerly professor at the City University of Hong Kong and pro-vice-chancellor of OP Jindal Global University, India.</em></p>
<hr>
<p><em>* Clarification: the Australian Human Rights Commission report, Change the Course, found as many as half (51%) of all Australian university students were sexually harassed in 2016. Just under half of these (21% of all students) were on campus.</em></p><img src="https://counter.theconversation.com/content/147849/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This article was co-authored by D.K. Srivastava – formerly professor at the City University of Hong Kong and pro-vice-chancellor of OP Jindal Global University, India.</span></em></p><p class="fine-print"><em><span>Aashish Srivastava and Neerav Srivastava do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Australia lacks standalone hazing legislation that clearly makes it the responsibility of universities, but courts here and overseas are increasingly likely to find them liable for the harm done.Aashish Srivastava, Senior Lecturer, Department of Business Law and Taxation, Monash UniversityNeerav Srivastava, PhD Candidate, Centre for Commercial Law and Regulatory Studies, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1330202020-03-10T12:03:18Z2020-03-10T12:03:18ZWhy young people are drinking less – and what older drinkers can learn from them<figure><img src="https://images.theconversation.com/files/319372/original/file-20200309-118881-yfv6vg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Mocktail anyone?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/friends-having-fun-drinking-cocktails-outdoor-384652753">Jacob Lund / Shutterstock</a></span></figcaption></figure><p>Young people are drinking less than ever before. Some reading this will be able to recall the 1990s – the decade of peak alcohol, when drinking was a key part of life for young people. The decade saw the rise of pub and club culture, public displays of drunkenness by young adults and the arrival of new kinds of alcoholic drinks you could buy (alcopops anyone?).</p>
<p>Flash forward to 2020 and the picture is very different. A range of studies from countries where drinking is a big part of the culture confirms a sharp decline in alcohol consumption among young people. <a href="https://academic.oup.com/alcalc/article/49/6/681/2888128">Research in Sweden</a>, for example, shows a decline across all types of consumption, from the heaviest to the lightest drinkers. Similarly, rates of binge drinking have gone down and people defining themselves as non-drinkers has increased. </p>
<p>There may be significant health benefits to this change in behaviour. Excessive alcohol consumption is the cause of a number of chronic diseases and bad drinking habits are <a href="https://www.thelancet.com/article/S0140-6736(18)31310-2/fulltext">often created between the ages of 16 and 25</a>. So there’s lots to be learnt from the young people who typify how drinking culture appears to be changing. </p>
<p>There are many reasons for the change, which I have recently brought together <a href="https://www.palgrave.com/gp/book/9783030286064">in a new book with my colleague Fiona Measham</a>. Economic factors, including a wider climate of constraint and austerity, may impinge the time and money young people have available to spend on alcohol. Young people may also be more aware of <a href="https://www.who.int/substance_abuse/publications/alcohol_2014/en/">alcohol’s health risks</a>. </p>
<p>But changes in drinking behaviour may be just one part of <a href="https://www.simonandschuster.com/books/iGen/Jean-M-Twenge/9781501152016">broader changes in today’s super-connected youth culture</a>. For example, online technology has made friends and family now instantly accessible via social media and smartphones, and the once central role of pubs and clubs for initiating and consolidating social networks appears to have changed.</p>
<p>The decline could also simply be a redressing of the balance that began with the surge in alcohol’s popularity during the 1990s. It is unclear what the definitive reason is for the change that has taken place. But there is still plenty to learn from these changes in terms of how to encourage others to adopt healthier drinking patterns.</p>
<h2>Pros and cons of not drinking</h2>
<p>Choosing not to drink alcohol can have implications for people’s social lives. I <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12610">carried out a study</a>, surveying 500 UK university students who were alcohol drinkers but who were asked about whether they had recently not drank alcohol on social occasions where their peers were drinking. </p>
<p>Nearly half (44%) of the students reported having socialised without drinking alcohol, and reported benefits including higher self-esteem and feeling more productive in life. The main downsides were concerns that not drinking might limit their social lives and fear of missing out. The high proportion of students who had abstained from social drinking in the previous week while in the company of alcohol-consuming friends suggests that going dry while socialising may be more widespread among young adults who do regularly consume alcohol than is typically acknowledged in popular culture.</p>
<p>Not drinking has gained cultural visibility in recent years with the rise of phenomena like <a href="https://theconversation.com/dry-january-is-it-worth-giving-up-alcohol-for-a-month-51956">Dry January</a>. But questions circle around these initiatives. There is currently limited evidence that these events translate into longer-term moderate drinking and whether or not they target those in the most need of curbing their alcohol consumption is also <a href="https://theconversation.com/dry-january-helps-us-control-our-drinking-but-its-no-excuse-to-binge-the-rest-of-the-year-36920">open to question</a>. So it seems we’re still some way off harnessing non-drinking as a way to promote moderate alcohol consumption over a sustained period.</p>
<h2>Beating the stigma</h2>
<p>One of the biggest roadblocks to encouraging young people to drink less is the stigma there still is around not drinking or even drinking in moderation. Many studies point to this, particularly among students. In <a href="https://link.springer.com/article/10.1007/s11469-017-9848-6">one study I worked on</a>, interviewees have spoken of experiencing peer pressure to drink, and if they don’t drink alcohol feeling like they “don’t belong” or even excluded.</p>
<p>Another study suggests that male non-drinkers may face a double whammy of stigma. Their decision to not drink clashes with expectations of being both a young person (where drinking to excess demonstrates “living life to the full”) and gender role specific expectations (being told: “Why are you not having a drink? Man up!”). </p>
<p>Nonetheless, we can expect to see a growth in tolerance toward different drinking behaviour, as more people decide to drink less. This may unlock all sorts of possibilities when it comes to promoting moderate drinking across the population at large. The rise in interest in drink-free challenges, for example, and healthier lifestyles more generally, suggests the cultural climate is ripe for putting non-drinking centre stage in public health promotion materials. </p>
<p>Also, the emergence of “sober spaces” in young adult social environments is significant. For example, the rise of cafe culture, increased demand for <a href="https://www.bbc.co.uk/news/uk-45171571">living accommodation where alcohol use is prohibited</a> and activities like <a href="https://link.springer.com/chapter/10.1007/978-3-030-28607-1_12">sober raves and the “conscious clubbing” movement</a>. Pubs and clubs are no longer the go-to space for people to socialise, thanks to diverse cultural factors including increased numbers of young people who do not drink and the increased acceptability of non-drinking as a social option. </p>
<p>Understanding these changes is an ongoing process. But shifts in how alcohol is viewed by young adults shows that excessive drinking doesn’t have to be the default way of socialising and perhaps we can all have a healthier relationship with booze.</p><img src="https://counter.theconversation.com/content/133020/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dominic Conroy received funding from the Economic and Social Research Council (ESRC) for his PhD research in 2011-2014.</span></em></p>Shifts in how alcohol is viewed by young people shows that excessive drinking doesn’t have to be the default way of socialising.Dominic Conroy, Lecturer in Psychology, University of East LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1276772019-12-18T13:50:30Z2019-12-18T13:50:30ZAlcoholic? Me? How to tell if your holiday drinking is becoming a problem<figure><img src="https://images.theconversation.com/files/306883/original/file-20191213-85417-1cyweqm.jpg?ixlib=rb-1.1.0&rect=40%2C269%2C4452%2C2815&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Holiday drinking can get out of hand before we know it. It's important to know the signs of overuse.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/closeup-santa-claus-holding-mug-beer-160819868">Steve Cukrov/Shutterstock.com</a></span></figcaption></figure><p>It’s the most wonderful time of the year, when holiday parties collide with collegiate and professional athletics events. What do they all have in common? Booze, lots of it, and often free. It’s no wonder the lead reindeer has a red nose. </p>
<p>Of course, drinking isn’t limited to a single season, but it holds a prominent place during the holidays. Across a few short weeks, consumption of spiked cider, boozy nog, wine, beer, cocktails and variations thereof may be higher than at any other point in the year. One industry study suggested that <a href="https://www.beveragedaily.com/Article/2018/12/19/Americans-double-their-drinking-during-the-holidays-dampen-work-productivity">drinking doubles</a> at this time of year. During this party time, we see up close the drinking habits of our partners, co-workers, relatives and, of course, ourselves. </p>
<p>This holiday season, you might take notice of just how much you drink. You may start to question your motivation for drinking. Or wonder about the long-term effects. While it might be tempting to dismiss these unsettling reflections, as director of the University of Florida <a href="https://scholar.google.com/citations?user=sV9Rcl0AAAAJ&hl=en">Center for Addiction Research and Education</a>, I encourage you not to.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/306888/original/file-20191213-85422-regkg6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/306888/original/file-20191213-85422-regkg6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/306888/original/file-20191213-85422-regkg6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/306888/original/file-20191213-85422-regkg6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/306888/original/file-20191213-85422-regkg6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/306888/original/file-20191213-85422-regkg6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/306888/original/file-20191213-85422-regkg6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sometimes one drink is too many.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-barman-hand-pouring-alcohol-into-180188297">bogdanhoda/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>How many is too many?</h2>
<p>About one in eight U.S. adults <a href="https://doi.org/10.1001/jamapsychiatry.2017.2161">met criteria for an alcohol use disorder</a> in 2013 – the most recent year for which we have data. Compare that to just over one in 12 in 2002. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710229/">That’s a nearly 50% increase</a>.
Alcohol misuse can lead to interpersonal violence and physical injury and worsen medical and psychiatric conditions. Besides its impact on health and well-being, alcohol misuse costs the <a href="https://www.cdc.gov/pcd/issues/2014/13_0293.htm">U.S. an estimated US$224 billion</a> a year in lost productivity, health care costs, criminal justice costs and others. More than 75% of those costs are associated with binge drinking.</p>
<p>But these statistics don’t answer the question I get most often from friends, family, casual acquaintances and even strangers at parties or on cross-country flights. What everyone wants to know is, “How much can I drink without being an alcoholic?” The answer is, “It depends.” </p>
<h2>For starters, stop calling names</h2>
<p>To effectively address the question, we must rethink our use of the term “alcoholic.” People have disorders; they are not themselves <a href="https://doi.org/10.1177%2F002204261004000403">these disorders</a>. The distinction is not merely a matter of semantics. It is fundamental to eliminating the stigma of substance use disorders and other psychiatric conditions. </p>
<p>Still, the more appropriate question, “How much can I drink without developing an alcohol use disorder?” gets the same answer: It depends. The amount that a person drinks <a href="https://www.psychologytoday.com/us/blog/the-athletes-way/201506/what-are-the-eleven-symptoms-alcohol-use-disorder">doesn’t directly determine an alcohol use disorder diagnosis</a>. But how can a “drinking problem” not have a definitive cutoff? </p>
<p>That’s because two people could drink the same amount and experience completely different consequences. So, the diagnostic criteria for alcohol use disorder focus on those consequences, rather than number of drinks imbibed. </p>
<p>For example, <a href="https://www.psychologytoday.com/us/blog/the-athletes-way/201506/what-are-the-eleven-symptoms-alcohol-use-disorder">inability to control your drinking</a>, no matter how much you drink, is a red flag. Having cravings for alcohol is another one. Does drinking interfere with your work, school or home responsibilities? Do you drink in situations in which you know it’s risky to do so? </p>
<p>Of course, the more you drink, the more likely it is that you will experience negative consequences. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/306891/original/file-20191213-85417-syjcpm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/306891/original/file-20191213-85417-syjcpm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/306891/original/file-20191213-85417-syjcpm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/306891/original/file-20191213-85417-syjcpm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/306891/original/file-20191213-85417-syjcpm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/306891/original/file-20191213-85417-syjcpm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/306891/original/file-20191213-85417-syjcpm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There are resources available to help you know if are drinking too much.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/drinking-much-during-christmas-time-new-205310098">and-one/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Risky business</h2>
<p>Most drinkers do not develop a disorder. But that doesn’t mean you’re off the hook. Research shows that Americans are drinking more and for longer each time they drink than ever before. And, adults are <a href="https://www.doi.org/10.1111/acer.13365">continuing to drink into older ages</a> than ever before. </p>
<p>Women, in particular, seem to drink more as they age. A significant percentage of drinkers over age 55 often exceed the National Institute of Alcohol Abuse and Alcoholism’s <a href="https://doi.org/10.1016/j.drugalcdep.2018.02.031">suggested guidelines for moderate drinking</a> without necessarily meeting criteria for an alcohol use disorder. Whether you have a diagnosable disorder or not, all this drinking can cause problems. </p>
<p>One of those problems is driving. People mistakenly think of this as a young person’s problem. But about one in four adults 45 to 64 and another one in 12 over age 65 <a href="https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/811342.pdf">report driving after drinking in the previous month</a>. </p>
<p>At blood alcohol concentrations equivalent to one or two drinks, older adults show notable shifts in cognitive performance, neural activity and driving strategies compared to younger ones. </p>
<p>Putting all this in the context of the holidays, it’s not just the pervasive presence of booze that makes us drink. It’s the party culture. If you’re seen without a drink, you are often encouraged to take one. If you lose track of your drink, you get another (full) one.</p>
<p>This excess may meet criteria for a binge drinking episode. For women, that’s <a href="https://www.rethinkingdrinking.niaaa.nih.gov/">four or more standard drinks</a> in a single occasion. For men, it’s five or more. And, as for “standard” drinks, we all know that many of us are typically pouring ourselves two to three times the standard in every glass. </p>
<p>Binge drinking, too, is increasing in older adults. And that matters because it has an immediate impact on driving abilities, fall risk and prescription medications. </p>
<h2>Should I take action?</h2>
<p>If your alcohol use is gnawing at your conscience, you have options. Talk candidly with a trained professional about your drinking. Access the <a href="https://www.niaaa.nih.gov">National Institute of Alcohol Abuse and Alcoholism website</a>, where you can assess your drinking and seek help. If you believe a friend or relative has a problem, talk with someone who can help you identify next steps.</p>
<p>Here are some ways to be a safer drinker:</p>
<ul>
<li>Before that party, eat something, even if you have to eat it in the car.<br></li>
<li>Make your first drink nonalcoholic. It keeps you from gulping down the first “real” drink and allows your “car snack” time to settle.<br></li>
<li>Alternate alcoholic and nonalcoholic drinks. </li>
<li>Eat (actually, graze) throughout the evening. Assuage guilt about calories by prioritizing fitness.<br></li>
<li>Disregard peer pressure. Susceptibility to it may lessen with age, but seldom vanishes. When you reach your limit, don’t be swayed. </li>
<li>To escape from an awkward conversation, don’t make a beeline to the bar. Take an indirect route through the room, mingling, checking out decorations. </li>
<li>Take a ride-share home or to and from a party. </li>
</ul>
<p>If you think your holiday drinking could be a sign of a year-round issue, discuss it with a medical or behavioral health provider. There are a variety of options, including the support and help of Alcoholics Anonymous, which is free. Online AA meetings are also available. For more information, visit: https://www.aa.org.</p>
<p>[ <em><a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=expertise">Expertise in your inbox. Sign up for The Conversation’s newsletter and get a digest of academic takes on today’s news, every day.</a></em> ]</p><img src="https://counter.theconversation.com/content/127677/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sara Jo Nixon receives funding from the National Institutes of Health. She is affiliated with the American Psychological Association where she serves on the Advocacy Coordinating Committee. . </span></em></p>The holidays are not solely about religious observations or societal celebrations, as alcohol has established itself in the festivities. But how much is too much? An addiction specialist examines.Sara Jo Nixon, Professor of Psychology and Psychiatry, University of FloridaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1273132019-11-21T19:42:19Z2019-11-21T19:42:19ZBrain activity predicts which mice will become compulsive drinkers<figure><img src="https://images.theconversation.com/files/302787/original/file-20191120-515-1yve1an.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Can the activity in brain circuits predict who is vulnerable to excessive drinking?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/brain-glass-alcohol-drink-alcoholism-concept-600714989">AlexLMX/Shutterstock.com</a></span></figcaption></figure><p>Some individuals consume alcohol their entire adult life without developing an alcohol use disorder. Others, however, quickly transition to compulsive and problematic drinking. Can we determine what makes some people vulnerable to addiction?</p>
<p>Alcohol drinking is the <a href="https://doi.org/10.1001/jama.291.10.1238">third leading cause of preventable death</a> in the United States, and is responsible for millions of deaths per year worldwide. If the reasons why some people are susceptible to alcohol use disorder were known, it might be possible to more effectively treat this devastating disease, or even intervene before serious problems emerge. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=612&fit=crop&dpr=1 600w, https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=612&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=612&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=769&fit=crop&dpr=1 754w, https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=769&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/302955/original/file-20191121-483-10fu3vw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=769&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">How much drinking is excessive?</span>
<span class="attribution"><a class="source" href="https://www.cdc.gov/alcohol/onlinemedia/infographics/excessive-alcohol-use.html">CDC</a></span>
</figcaption>
</figure>
<p>I have <a href="https://scholar.google.com/citations?hl=en&user=JJ14QfUAAAAJ">spent my career</a> as a neuroscientist and pharmacologist trying to understand how drugs and alcohol act on the brain, and what makes a brain more or less susceptible to substance use disorders. <a href="https://sicilianolab.com">My laboratory</a> at the <a href="https://medschool.vanderbilt.edu/vcar/">Vanderbilt Center for Addiction Research</a> develops approaches for studying addictive behaviors in rats and mice. Using <a href="https://sicilianolab.com/research/techniques">electrochemical and optical approaches</a> to measure brain activity, our goal is to determine how patterns of activity in brain cells give rise to these behaviors – and how we may use this information to treat or prevent substance use disorders. </p>
<p>In a report published in the <a href="https://science.sciencemag.org/lookup/doi/10.1126/science.aay1186">Nov. 22 issue of the journal Science</a>, <a href="https://www.salk.edu/scientist/kay-tye/">Kay Tye of the Salk Institute</a> and I set out to understand how binge drinking alters the brain and how this can lead to compulsive behaviors in some drinkers. </p>
<h2>Testing for compulsive drinking</h2>
<p>To study this, we designed an experiment in which mice were scored for their propensity to drink alcohol. We measured compulsive drinking by determining how much they drank when we mixed the alcohol with a bitter tasting substance that mice normally avoid. </p>
<p>After assessing levels of compulsive drinking in each mouse, mice were allowed to binge drink for several weeks, during which they consumed large amounts of alcohol daily. Then compulsive drinking was measured again. This allowed for tracking the development of excessive and compulsive drinking behaviors across time and experience.</p>
<p>Initially, all of the mice in our experiment had very similar drinking behaviors. However, even though the mice were all genetically identical, after binge drinking there was wide variability that enabled us to divide the mice into three distinct groups. After binge drinking, some mice drank large amounts, and continued to drink even when the alcohol was made bitter. We classified these mice as “compulsive drinkers.” The next group was designated as “high drinkers.” These mice drank large amounts of alcohol, but quickly stopped when the alcohol was bitter. “Low drinkers” had the lowest levels of alcohol consumption under both conditions. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=233&fit=crop&dpr=1 600w, https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=233&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=233&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=293&fit=crop&dpr=1 754w, https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=293&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/302956/original/file-20191121-524-lxp9k2.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=293&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">What is considered a single serving of a drink?</span>
<span class="attribution"><a class="source" href="https://www.cdc.gov/alcohol/onlinemedia/infographics/excessive-alcohol-use.html">CDC</a></span>
</figcaption>
</figure>
<h2>Brain circuit activity predicts compulsive drinking</h2>
<p>We wanted to understand how a group of neurons connecting two brain regions, called the medial prefrontal cortex and the dorsal periaqueductal gray area, contribute to compulsive drinking behaviors. The prefrontal cortex is involved in decision making; the dorsal periaqueductal gray area processes painful and aversive events.</p>
<p>We reasoned that the communication between these two regions might be critical in determining how subjects make decisions when negative outcomes (like bitter taste) are paired with drinking. Using an approach called <a href="https://static1.squarespace.com/static/5d27c543eea0d500016ccf1d/t/5d6ebf3ea2517200013d331c/1567539009396/leveraging-calcium-imaging-to-illuminate-circuit-dysfunction-in-addiction.pdf">calcium imaging</a>, we were able to observe the activity of these neurons while the mice drank.</p>
<p>The initial hypothesis was that binge drinking would disrupt the ability of this neural circuit to respond appropriately to events in the environment. However, we were surprised to discover early on in these experiments that each of the three groups of mice had very distinct brain activity patterns the first time the mice drank alcohol, even though the behavior of these three groups of mice was the same at this point in time. </p>
<p>Mice that progressed to become compulsive showed less brain activity in this pathway during early exposure to alcohol. Those that showed little interest in alcohol and were easily put off by the bitter taste showed increased activity in these same neurons during drinking.</p>
<p>By examining the neural response to alcohol prior to the binge drinking, we could predict which mice would eventually become compulsive drinkers. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/303008/original/file-20191121-524-1daixd6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cells in the medial prefrontal cortex are labeled in blue. The medial prefrontal cortex neurons that connect and send messages to the dorsal periaqueductal gray area are labeled in green.</span>
<span class="attribution"><span class="source">Cody Siciliano</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<h2>Altering drinking behaviors</h2>
<p>In a separate experiment, we used a technique called optogenetics, where light-sensitive proteins are introduced to the mouse’s brain cells so that their activity can be controlled with pulses of light, to manipulate the activity of this population of neurons.</p>
<p>By artificially reproducing the brain activity patterns we observed in the compulsive mice, we were able to cause compulsive drinking behaviors even in mice that had never had a binge drinking experience. Conversely, by driving excitatory activity in these neurons during alcohol drinking, just like we observed in the low drinking animals, we were able to decrease drinking. </p>
<p>It seems as if this medial prefrontal cortex-dorsal periaqueductal gray circuit acts like a gate for compulsive drinking. When there is increased activity in these brain cells during alcohol drinking, a mouse is less likely to drink again in the future. When there is decreased activity during drinking, the mice are prone to drink again, even if that means suffering a negative consequence. What causes these differences in activity in individual mice is still unclear.</p>
<p>Although much more research is required before these findings can be applied to humans, we believe this study provides critical insights into the neurobiological mechanisms that predispose some users to alcohol use disorders. </p>
<p>Understanding the neural mechanisms controlling the behavioral processes that ultimately lead to substance use disorder is the critical first step to developing treatments to reduce excessive alcohol drinking. Importantly, these findings suggest that may we may be able to identify at risk individuals, based on neural activity patterns, and intervene before an alcohol use disorder fully develops. </p>
<p>[ <em>Like what you’ve read? Want more?</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=likethis">Sign up for The Conversation’s daily newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/127313/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Cody A. Siciliano receives funding from the National Institutes of Health, and the Brain and Behavior Research Foundation. </span></em></p>One in six US adults binge drinks, consuming about seven drinks per binge. A new study can predict which mice are hardwired to binge drink. Is it possible to do the same for humans?Cody A. Siciliano, Assistant Professor of Pharmacology, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1245442019-10-11T13:53:07Z2019-10-11T13:53:07ZThere’s a binge drinking boom among older people – and here’s what that could be doing<figure><img src="https://images.theconversation.com/files/296533/original/file-20191010-188835-1uza268.jpg?ixlib=rb-1.1.0&rect=11%2C0%2C3870%2C2485&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Approximately 1 in 10 people over 65 engage in binge drinking.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/chaos-beer-on-wooden-table-bottles-365244674?src=KmGex01kZvT4yj6xUTwGaw-1-75">Artem Shadrin/ Shutterstock</a></span></figcaption></figure><p>Although enjoying a glass of red wine now and again may be healthy for your <a href="https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.117.030387">heart</a> and <a href="https://theconversation.com/why-a-glass-of-red-wine-is-good-for-your-gut-122072">gut</a>, drinking too much alcohol can put you at higher risk of developing many serious health conditions. Heavy alcohol consumption has been linked to a <a href="https://www.nhs.uk/live-well/alcohol-support/the-risks-of-drinking-too-much/">number of health issues</a>, including developing certain types of cancer, stroke, heart and liver disease, and brain damage. In older people, drinking unhealthy levels of alcohol can be <a href="https://www.nia.nih.gov/health/facts-about-aging-and-alcohol">even more damaging to health</a>, and may cause memory loss, high blood pressure, balance problems, and worsen mental health. </p>
<p>But while many might assume that alcohol is only damaging to those who regularly drink above the recommended limits, research has also shown that <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf">binge drinking can be just as harmful</a>. Binge drinking is defined as consuming at least eight units of alcohol for men (approximately four pints of beer), and six units for women, in one sitting. Binge drinking has been shown to increase the risks of death from long-term illness, accidents, and injuries. </p>
<p><a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf">Current guidelines</a> recommend people don’t drink more than 14 units of alcohol per week. That’s equivalent to seven pints of beer, or just over a bottle of wine per week. </p>
<p>Although binge drinking is <a href="https://bmjopen.bmj.com/content/3/4/e002337.short">often associated with younger people</a>, approximately <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/datasets/adultdrinkinghabits">one in 10 people aged 65 and over</a> engage in binge drinking.</p>
<p>Recently, researchers looked at <a href="https://bmjopen.bmj.com/content/3/4/e002337.short">alcohol use and risky drinking patterns</a> in older people – specifically, its relationship to other mental disorders, such as depression and dementia. It found that one in four drinkers consumed alcohol above weekly limits and more than one in five drinkers reported binge drinking over the past 12 months.</p>
<h2>Mental health and alcohol abuse</h2>
<p>Hospital admissions for mental disorders related to alcohol has <a href="https://www.dailymail.co.uk/health/article-7518507/Baby-boomers-overtake-young-people-countrys-problem-drinkers.html">risen by 21% over the past five years</a> in people aged 50 and over. These admissions are due to a range mental disorders from alcohol dependence and intoxication to memory disorders such as dementia and <a href="https://www.alzheimers.org.uk/sites/default/files/pdf/factsheet_what_is_alcohol-related_brain_damage.pdf">Korsakoff’s syndrome</a>. Unfortunately, this is a trend that has only worsened <a href="https://theconversation.com/having-lived-hedonistic-lives-the-baby-boomers-are-drinking-themselves-into-an-early-grave-64016">over the past 15 years</a> as the “baby boomer” generation has aged. </p>
<p>In order to understand more about the impact of alcohol consumption on mental disorders, researchers looked at 190 patients aged 65 and over who were enrolled in a mental health service for older adults. The patients had a range of mental disorders, including depression and dementia. Only a third of the patients were female. </p>
<p>Using the <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684823/Alcohol_use_disorders_identification_test__AUDIT_.pdf">Alcohol Use Disorders Identification Test</a> (AUDIT), researchers asked participants a series of questions to rate a person’s risk of alcohol related harm. </p>
<p>The study found that men were one and a half times more likely than women to have current or past past alcohol related problems – such as injury due to alcohol consumption. They also scored an average of 2 points less on average on a <a href="https://www.ihpa.gov.au/sites/default/files/publications/smmse-guidelines-v2.pdf">dementia screening test</a>, which meant they were likely to be at a higher risk of developing dementia.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/296534/original/file-20191010-188819-1hl8vs8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/296534/original/file-20191010-188819-1hl8vs8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/296534/original/file-20191010-188819-1hl8vs8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/296534/original/file-20191010-188819-1hl8vs8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/296534/original/file-20191010-188819-1hl8vs8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/296534/original/file-20191010-188819-1hl8vs8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/296534/original/file-20191010-188819-1hl8vs8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Alcohol related dementia is different from other types of dementia.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-senior-man-addicted-alcohol-305673407?src=_9SRE5w5V8ab7SPIJ7PNVA-1-2">Photographee.eu</a></span>
</figcaption>
</figure>
<p>There was also considerable variation in drinking patterns within participants. About one in eight patients reported drinking once a month or less, with the most common pattern being one to two units per month. However, this doesn’t indicate how much someone drank on these occasions – and whether it would be classified as binge drinking. This could only be discovered using the AUDIT questionnaire, which also asks about binge drinking. Routine clinical practices that do not use the AUDIT often only ask patients the average amount they drink per week, rather than the maximum amount on any one day. This would mean missing out valuable information about binge drinking.</p>
<h2>Providing support</h2>
<p>This study shows that many older people aren’t receiving much support when it comes to monitoring and reducing their drinking behaviours. It showed that many older people aren’t often asked about their drinking habits – something that health care practitioners <a href="https://digital.nhs.uk/data-and-information/publications/statistical/smoking-drinking-and-drug-use-among-young-people-in-england/2018">are more likely to ask younger people</a>.By asking more often, health care workers might be able to <a href="https://www.tandfonline.com/doi/abs/10.1080/17523281.2012.754785">help reduce</a> risky drinking behaviours by providing the right support and help in reducing alcohol consumption. </p>
<p>The study also found that older men who regularly drink above weekly limit or binge drink are at higher risk of developing certain types of dementia. Alcohol related dementia is <a href="https://www.emerald.com/insight/content/doi/10.1108/ADD-06-2016-0014/full/htm">different from other types of dementia</a>, as it damages the frontal lobes of the brain and may lead to <a href="https://www.emerald.com/insight/content/doi/10.1108/ADD-06-2016-0014/full/html">changes in personality</a>, such as being more impulsive and having difficulty controlling emotions. </p>
<p>Not only can having an expert diagnosis help with treatment, it also means alcohol related dementia can be detected in its early stages – which might mean some of its <a href="https://www.mentalhealthtoday.co.uk/alcohol-related-dementia-under-detected-unique-in-profile-and-often-partially-reversible">effects can be partially reversed</a>. </p>
<p>New clinical services that can assess both <a href="https://www.emerald.com/insight/content/doi/10.1108/17570971111155595/full/html">alcohol related disorders and mental health disorders</a> might be one way of ensuring that older adults receive necessary support and treatment for both mental health and disordered drinking.</p>
<p>The government has also <a href="https://www.england.nhs.uk/wp-content/uploads/2019/09/community-mental-health-framework-for-adults-and-older-adults.pdf">created guidance</a> to help detect and reduce alcohol related harm to older people. Mental disorders and risky drinking can be present at the same time in older people, but the common perception is that these are problems that <a href="https://www.bmj.com/content/366/bmj.l5112">only affect younger people</a>. By creating greater support and a sense of community for those suffering, it can help aid in treatment and prevent binge drinking for continuing to be an undetected problem in older populations.</p><img src="https://counter.theconversation.com/content/124544/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tony Rao does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Providing support and treatment might help reduce harmful drinking behaviours in seniors.Tony Rao, Visiting Lecturer in Old Age Psychiatry, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1243012019-10-02T11:01:32Z2019-10-02T11:01:32ZDepression and binge-drinking more common among military spouses and partners<figure><img src="https://images.theconversation.com/files/294823/original/file-20190930-194829-wuso4z.jpg?ixlib=rb-1.1.0&rect=0%2C9%2C6016%2C3998&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/depressed-beautiful-woman-drinking-wine-692074012?src=1pf9L49xDGDOugHsFri3Yg-1-6">shutterstock/Dmytro Zinkevych</a></span></figcaption></figure><p>For those in the military, high levels of dedication and commitment are expected from day one on the job – and this includes the risks that come with combat deployments. There can also be demands on the partners and children of those in service: including regularly moving, family separation, worries about deployed personnel, and problems during homecoming. All can be frequent experiences for military families and can adversely affect <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1745-7599.2012.00809.x">the health and well-being of family members</a>. </p>
<p><a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/mental-health-outcomes-at-the-end-of-the-british-involvement-in-the-iraq-and-afghanistan-conflicts-a-cohort-study/E77CCC4B6D0B2A3B6A481C0980D29E93">Previous research</a> has found alcohol is a common problem in the UK armed forces. And <a href="https://www.tandfonline.com/doi/full/10.1080/20008198.2019.1654781">our latest study</a> has also found that alcohol is a problem for female spouses and partners of military personnel – who are more than twice as likely to report binge-drinking and depression than women in the general population.</p>
<p>There are approximately <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/330339/PUBLIC_1405331876.pdf">70,000</a> military families in the UK. But not a lot is known about families’ experience of military life, as most research to date has been based in the US. Some of these studies have found high levels of <a href="https://www.ncbi.nlm.nih.gov/pubmed/23997822">depression</a> and <a href="https://ps.psychiatryonline.org/doi/pdf/10.1176/ps.62.1.pss6201_0028">post-traumatic stress disorder</a> (PTSD) among military partners, especially when personnel are on combat missions. But there are <a href="https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2018/gribble2018.pdf">few studies</a> looking at levels of alcohol use in this group. </p>
<p><a href="https://www.tandfonline.com/doi/full/10.1080/20008198.2019.1654781">Our study</a> is the first to find out more about the health and well-being of UK military partners. We used data from <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/impact-of-paternal-deployment-to-the-conflicts-in-iraq-and-afghanistan-and-paternal-posttraumatic-stress-disorder-on-the-children-of-military-fathers/0175F9117E1BFA4136C28F2DB7A3BD6C">studies</a> at the <a href="http://www.kcl.ac.uk/kcmhr">King’s Centre for Military Health Research</a>, King’s College London. We looked at mental health problems – including depression and PTSD among 405 female military partners – all of whom had children. We also looked at their alcohol use. </p>
<p>We then compared the number of military partners showing signs of mental health and alcohol problems to women in the general population who also had children. For this, we used data from the 2007 <a href="https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/adult-psychiatric-morbidity-in-england-2007-results-of-a-household-survey">Adult Psychiatric Morbidity Survey</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/294825/original/file-20190930-194832-1gbk5en.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/294825/original/file-20190930-194832-1gbk5en.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/294825/original/file-20190930-194832-1gbk5en.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/294825/original/file-20190930-194832-1gbk5en.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/294825/original/file-20190930-194832-1gbk5en.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/294825/original/file-20190930-194832-1gbk5en.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/294825/original/file-20190930-194832-1gbk5en.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">At times, life can be challenging for military families.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sad-african-daughter-mother-sitting-on-1332865535?src=iUTPe_QTiaQpNIYTMNyzCw-1-6">Shutterstock/fizkes</a></span>
</figcaption>
</figure>
<p>We found that generally most UK military partners were doing well but that female spouses and partners of military personnel were more likely to have depression and to report binge-drinking than women in the general population. Further tests found that binge-drinking in military partners was linked to longer absences of military personnel from the family home – suggesting poor coping during this time. </p>
<p>We did not find any factors linked to depression but military partners in some of our other research have talked about how some parts of military life, such as regular <a href="https://www.kcl.ac.uk/kcmhr/publications/reports/files/gribble2019.pdf">family separation</a>, difficulties <a href="https://www.kcl.ac.uk/kcmhr/publications/reports/files/gribble2017-report.pdf">with social connections</a> and <a href="https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2019/Gribble2019.pdf">partner employment and training</a> have negatively affected their health and well-being. The stresses of <a href="https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2016/Thandi-2016.pdf">caregiving</a>, especially for former service personnel with <a href="https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2018/murphy2018a.pdf">PTSD</a>, can also negatively affect military partner mental health. </p>
<h2>Alcohol interventions</h2>
<p>More research is now needed to help find out more about what drives depression and problem drinking among military partners. But GPs and other professionals who have regular contact with military families would also benefit from being aware of these findings so they can help support military partners who may be struggling. </p>
<p>To better understand the health of this population and target support where needed, the NHS should also routinely collect data on whether someone is the spouse or partner of someone in the UK Armed Forces. The mental health of the <a href="https://www.kcl.ac.uk/kcmhr/publications/reports/files/gribble2018.pdf">other family members</a>, – such as parents and siblings – who are not often thought about in research, should also be looked at to better understand the impacts of service life on the wider family.</p>
<p>Campaigns aimed at reducing alcohol use in military families would also be beneficial. This could include adapting programmes and <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/630184/20170718_Alcohol_Usage_bulletin__-_O.pdf">interventions</a> that address drinking among service personnel. Research, for example, has found that <a href="https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2018/Leightley2018a.pdf">mobile apps</a> can be helpful in tracking and reducing alcohol use among former service personnel – so a similar approach may also work for military partners. </p>
<p><em>Military spouses or partners who feel they are having problems should speak to their GP or to the <a href="https://nff.org.uk/">Naval</a>, <a href="https://aff.org.uk/">Army</a> or <a href="https://www.raf-ff.org.uk/">RAF</a> Family Federations</em></p><img src="https://counter.theconversation.com/content/124301/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The main findings of this piece relating to mental health and alcohol use among UK military partners were part of a PhD studentship funded by the Economic and Social Research Council and the Army Families Federation. </span></em></p>New research suggests the partners of UK military personnel may experience greater levels of depression and binge-drinking compared to women in the general population.Rachael Gribble, Lecturer, War & Psychiatry, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1211152019-08-12T20:03:40Z2019-08-12T20:03:40ZQueenslanders are among our heaviest drinkers on nights out, and changing that culture is a challenge<figure><img src="https://images.theconversation.com/files/287143/original/file-20190807-84240-1kugd6f.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Queenslanders are drinking heavily when they go out and breathalyser tests show most don't realise how drunk they are.</span> </figcaption></figure><p><em>This is the second in a <a href="https://theconversation.com/au/topics/quantem-74665">series of articles</a> discussing a <a href="http://statements.qld.gov.au/Statement/2019/7/26/evaluation-of-measures-to-tackle-alcoholfuelled-violence">recently released</a> <a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">comprehensive evaluation</a> of the Queensland government’s <a href="https://www.legislation.qld.gov.au/view/html/asmade/act-2016-004#">2016 policy reforms to tackle alcohol-fuelled violence</a> and the implications for liquor regulation and the night-time economy in Queensland and Australia. A <a href="http://quantem.info/">summary report</a> is also available.</em></p>
<hr>
<p><a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">Our evaluation</a> of the Queensland government’s 2016 “<a href="https://www.thepremier.qld.gov.au/newsroom/alcohol-fuelled-violence.aspx">Tackling Alcohol-Fuelled Violence</a>” (TAFV) policy has found Queenslanders are still drinking more heavily than people in other states when going out at night. </p>
<p>Despite <a href="https://theconversation.com/lessons-from-queensland-on-alcohol-violence-and-the-night-time-economy-121114">significant reductions in serious assaults and other health-related outcomes</a>, reported levels of aggression are also high. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/lessons-from-queensland-on-alcohol-violence-and-the-night-time-economy-121114">Lessons from Queensland on alcohol, violence and the night-time economy</a>
</strong>
</em>
</p>
<hr>
<p>Queenslanders report much higher levels of aggression than reported in our previous studies, which asked the same question in <a href="http://www.deakinvpg.info/dashed">Canberra, Hobart</a>, <a href="http://www.deakinvpg.info/pointed">Melbourne, Sydney, Perth, Wollongong, Geelong</a> and <a href="http://www.deakinvpg.info/dante">Newcastle</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=331&fit=crop&dpr=1 600w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=331&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=331&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=416&fit=crop&dpr=1 754w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=416&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/287147/original/file-20190807-84210-39li2s.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=416&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Table 1. Percentage of interviewees who report being involved in aggression in and around night-time entertainment precincts in the previous three months.</span>
<span class="attribution"><a class="source" href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Female patrons reported experiencing more of all types of aggression than men across all precincts. The next article in this series highlights the worrying number of women who experience unwanted sexual attention while out.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/unwanted-sexual-attention-plagues-young-women-going-out-at-night-121116">Unwanted sexual attention plagues young women going out at night</a>
</strong>
</em>
</p>
<hr>
<p>To measure the impact of the 2016 policy changes on alcohol consumption, illicit drug use and aggression, our research teams conducted <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4811-9">street intercept surveys</a> on Saturday nights in Fortitude Valley (Brisbane), Surfers Paradise and Cairns between 2016 and 2018. All participants were breathalysed. Every fifth person was invited to participate in a saliva drug swab. </p>
<p>Across the precincts, 4,401 people – 57% of them male – completed surveys. </p>
<h2>Blood alcohol concentration (BAC)</h2>
<p>Half of patrons’ blood alcohol concentration (BAC in g/dL) readings were over 0.077 (the median value, with a range of 0.000-0.300) in Fortitude Valley, 0.086 (range 0.000-0.290) in Surfers Paradise and 0.087 (range 0.000-0.289) in Cairns. The highest reading, 0.300, is six times the legal driving limit.</p>
<p>These median BAC levels are much higher than other, previously studied cities. The results highlight the challenges of achieving change in Queensland’s drinking culture.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=277&fit=crop&dpr=1 600w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=277&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=277&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=348&fit=crop&dpr=1 754w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=348&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/287337/original/file-20190808-144892-1m484o4.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=348&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Table 2. Patrons’ median blood alcohol concentration (BAC in g/dL) and range of readings.</span>
<span class="attribution"><a class="source" href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">QUANTEM final report</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Interestingly, most patrons are more drunk than they <em>think</em> they are. Before undertaking a breath test patrons were asked to guess their level of intoxication. For example, in Cairns, patrons’ median guess of their BAC reading was 0.070, compared to the measured median of 0.087. </p>
<h2>Pre-drinking</h2>
<p>High alcohol consumption when going out to night-time entertainment precincts includes <a href="https://academic.oup.com/alcalc/article/54/4/378/5486344">pre-drinking</a> (drinking at home before going out; also known as pre-gaming, pre-partying or pre-loading in other countries). As our research teams have documented <a href="http://www.deakinvpg.info/pointed">since 2012</a>, pre-drinking has continued to increase. </p>
<p>With 84% of all patrons reporting pre-drinking before going out, Queensland shows higher levels than in most other previously studied cities. </p>
<p>Overall, male patrons drank significantly more than female patrons when pre-drinking. In Fortitude Valley, though, female patrons were significantly more likely to pre-drink than males.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/womens-alcohol-consumption-catching-up-to-men-why-this-matters-67454">Women's alcohol consumption catching up to men: why this matters</a>
</strong>
</em>
</p>
<hr>
<p>It’s a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12525">common belief</a> that patrons choose to pre-drink to avoid buying more expensive drinks while they’re out in bars or clubs. But we found patrons who reported pre-drinking were more likely to drink more heavily across the night. They also reported drinking for longer than those who did not pre-drink.</p>
<p><a href="https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2019/5619T1074.pdf">Our report</a> also shows the rate of pre-drinking across the precincts remained mostly stable in the two years after the TAFV policy was introduced in 2016. This suggests it did not affect rates of pre-drinking.</p>
<h2>Illicit drug use</h2>
<p>Rates of self-reported illicit drug use varied between precincts, from 13% of patrons in Fortitude Valley to 25% of all patrons in Surfers Paradise.</p>
<p>Ecstasy was the most commonly used illicit substance reported by patrons (5.5%), followed by cannabis (4%).</p>
<p>Among those who completed saliva drug swabs, the most commonly detected substances were amphetamines in Fortitude Valley and Cairns. In Surfers Paradise, however, it was methamphetamine; with 23.5% of patrons interviewed in Surfers Paradise testing positive for the substance.</p>
<p>Although rates of illicit drug use fluctuated in the two years after the TAFV policy was introduced, overall rates remained largely stable. This indicates the policy did not result in a clear increase or decrease in illicit drug use.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fact-check-only-drugs-and-alcohol-together-cause-violence-12466">Fact check: only drugs and alcohol together cause violence</a>
</strong>
</em>
</p>
<hr>
<h2>So what does it all mean?</h2>
<p>Historically, Queensland has high levels of harmful consumption of alcohol, especially in high-risk groups. Around <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001%7E2017-18%7EMain%20Features%7EAlcohol%20consumption%7E100">46% of Queenslanders</a> have exceeded single-occasion risk guidelines in the past year, higher than in New South Wales and Victoria. </p>
<p>There has been significant investment in education campaigns across social media and in schools. Despite this, Queenslanders continue to show hazardous levels of alcohol consumption, illicit drug use and experiences of aggression. </p>
<p>Changing cultural patterns relating to pre-drinking and alcohol-related harms will not be easy. <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/dar.12274">Previous research</a> suggests further tightening of licensed venues’ trading hours will help. Our report recommendations include introducing a <a href="https://www.ncbi.nlm.nih.gov/pubmed/26098040">minimum unit price on alcohol</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/19594797">promoting low-risk drinking guidelines</a> at all points of sale across Queensland. </p>
<p>Our report also recommends trialling live music early in the night to try to bring people into entertainment districts earlier. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/tighter-alcohol-licensing-hasnt-killed-live-music-but-its-harder-for-emerging-artists-121117">Tighter alcohol licensing hasn't killed live music, but it's harder for emerging artists</a>
</strong>
</em>
</p>
<hr>
<p>Despite the promising results of government policy efforts to date, our evaluation suggests the work to reduce alcohol-related harm across Queensland is not finished. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/factcheck-can-you-change-a-violent-drinking-culture-by-changing-how-people-drink-38426">FactCheck: can you change a violent drinking culture by changing how people drink?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/121115/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jason Ferris receives funding from from Australian Research Council and Australian National Health and Medical Research Council, grants from State (Tasmania, Victoria, Queensland) and Federal Governments, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, University of Queensland, National Institute of Health, Global Drug Survey. He is affiliated with the Global Drug Survey and the Queensland Mental Health Commission.</span></em></p><p class="fine-print"><em><span>Cheneal Puljevic was a member of the research team led by Deakin University (Peter Miller) and The University of Queensland (Jason Ferris) to evaluate the Queensland Government’s “Tackling Alcohol-Fuelled Violence” (TAFV) legislation.</span></em></p><p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Central Australian Aboriginal Congress, Northern Territory government, Australian Rechabites Foundation, Northern Territory Primary Health Network, Lives Lived Well, Queensland government and Australian Drug Foundation, travel and related costs from Queensland Police Service, Queensland Office of Liquor Gaming and Racing and the Australasian Drug Strategy Conference. He has acted as a paid expert witness on behalf of a licensed venue and a security firm. </span></em></p><p class="fine-print"><em><span>Barbara Wood does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Even after ‘Tackling Alcohol-Fuelled Violence’ policies took effect in 2016, Queenslanders still drink more heavily on nights out. Reported levels of aggression are higher than in other states too.Jason Ferris, Associate Professor, Program Leader for Research and Statistical Support Service and Program Leader for Substance Use and Mental Health, Centre for Health Services Research, The University of QueenslandBarbara Wood, Research Assistant, The University of QueenslandCheneal Puljević, Research Fellow, Centre for Health Services Research, The University of QueenslandPeter Miller, Professor of Violence Prevention and Addiction Studies, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1064942018-12-19T11:42:20Z2018-12-19T11:42:20ZAre your grandparents getting tipsy at the holiday party?<figure><img src="https://images.theconversation.com/files/250085/original/file-20181211-76962-1oqjng9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Most people are fine with a drink, but when one becomes several, there may be a problem.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/laughing-man-bar-having-good-time-1020753541?src=e65sYkNLrCIg_ITZfwCUOQ-1-2">Zachary Byer/Shutterstock.com</a></span></figcaption></figure><p>November and December are defined by parties and social events. And in the U.S., alcohol is synonymous with socializing, with Americans particularly likely to overindulge during <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211338/">the holidays</a>.</p>
<p>Older people as a group have not historically imbibed during social events, particularly women. But recent evidence suggests that baby boomers may <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1360-0443.2008.02411.x">be shifting away from this trend</a>. As baby boomers have begun trickling into later life, the stereotype of Grandma sipping hot cocoa by the fire has slowly been replaced with Grandma sipping a glass of wine with her friends and family.</p>
<p>Is this new trend something we should be concerned about?</p>
<h2>A growing trend among older Americans</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/250736/original/file-20181214-185243-h0twr8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/250736/original/file-20181214-185243-h0twr8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=309&fit=crop&dpr=1 600w, https://images.theconversation.com/files/250736/original/file-20181214-185243-h0twr8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=309&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/250736/original/file-20181214-185243-h0twr8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=309&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/250736/original/file-20181214-185243-h0twr8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=388&fit=crop&dpr=1 754w, https://images.theconversation.com/files/250736/original/file-20181214-185243-h0twr8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=388&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/250736/original/file-20181214-185243-h0twr8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=388&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Drinking at social functions has become more widespread among older people than in years past.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-senior-retirement-meet-happiness-concept-507251209">Rawpixel.com/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Alcohol-related deaths have <a href="https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_05_tables.pdf">increased substantially</a> over the last decade, accounting for over <a href="https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm">88,000 deaths a year</a>; furthermore, the number of deaths related to alcohol-related liver disease, known as cirrhosis, <a href="https://www.bmj.com/content/362/bmj.k2817.full">has been rising in 49 states</a>. This trend has been driven in part by significant increases in alcohol consumption among older adults in recent years. </p>
<p>The prevalence of drinking among adults 60 and older has increased over time, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/acer.13365">especially among older women.</a> While men are still drinking more alcohol than women, older women today are drinking more than in the past, including taking part in binge drinking. Due to the large number and high substance use rates of the baby boomers, the number of older adults with substance abuse disorder is <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1360-0443.2008.02411.x">projected to double by 2020</a>.</p>
<p>The number of alcohol-related deaths is greater than the number dying due to opioids, though these two trends are not unrelated, as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935414/">the use of pharmaceutical opioids with alcohol is common.</a> Unlike opioid deaths, however, most alcohol-related deaths are not the consequence of a single event in which someone overindulged, unless that event involved a serious fall or a car accident. Alcohol-related deaths are usually a consequence of habitually drinking too much over an extended period of time, not just overindulging during one particularly social December. Moreover, low-to-moderate drinking has been shown to be potentially beneficial to physical and mental <a href="https://academic.oup.com/gerontologist/advance-article/doi/10.1093/geront/gny129/5144392">health among older adults</a>.</p>
<h2>‘Problem’ drinking is the key concern</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/250088/original/file-20181211-76956-ps1c0e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/250088/original/file-20181211-76956-ps1c0e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/250088/original/file-20181211-76956-ps1c0e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/250088/original/file-20181211-76956-ps1c0e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/250088/original/file-20181211-76956-ps1c0e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/250088/original/file-20181211-76956-ps1c0e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/250088/original/file-20181211-76956-ps1c0e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Driving becomes problematic for many older people, and drinking can only worsen the outcomes.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/detained-by-police-man-told-stand-1166459161?src=A_8rUK-jYVht2M7LwoR01g-2-34">mikedelray/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>If moderate alcohol consumption isn’t the issue, then what is? Put simply: problem drinking. Or rather, individuals who either binge drink or who consume 15 or more servings of alcohol per week – or both. It is this group that we health researchers and family members need to be paying particular attention to since rates are growing fastest among those middle-aged and in the early stages of later life (ages 45-65). </p>
<p>The <a href="https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics">National Institute on Alcohol Abuse and Alcoholism</a> defines binge drinking for men under age 65 as consuming five or more servings of alcohol in a single episode – the equivalent of drinking an entire bottle of wine, or more. For women of all ages and men over age 65, the threshold for binge drinking is lower – only four drinks. Among men between ages 60 and 70, about one in three report binge drinking compared to only one in 10 women in this age group. </p>
<p>In order to reduce these incidences of problem drinking, the <a href="https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics">National Institute on Alcohol Abuse and Alcoholism</a> recommends that adults over age 65 who are healthy and do not take medications limit their alcohol consumption to <a href="https://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/older-adults">three drinks in a given day and no more than seven drinks a week.</a></p>
<h2>The complicated relationship between socializing, alcohol and health</h2>
<p>The intersection between alcohol consumption, socializing and health is complicated. Research about the benefits of staying socially integrated and engaged in society is clear: Those who maintain meaningful relationships and engage regularly with others <a href="http://science.sciencemag.org/content/241/4865/540">live longer, healthier lives</a>. </p>
<p>However, how we “do” our socializing matters. One reason that individuals who are lonely experience poorer health outcomes is related to problem behaviors that occur as a way of dealing with the unpleasant feelings of loneliness. This includes <a href="https://www.jsad.com/doi/abs/10.15288/jsa.2001.62.190">excess alcohol consumption</a>. However, if socializing is conflated with heavy drinking or other unhealthy behaviors, being too social could also pose serious health problems. And the consequences of such behaviors could be magnified for older adults.</p>
<p>Alcohol can affect us differently as we age, and this relates, in part, to common changes we experience as we get older. Starting in our 40’s, we begin to lose muscle and bone density, with losses particularly significant for those who do not regularly exercise, those who are obese and those with poor nutrition. This loss of bone and muscle not only means that our bodies are worse at metabolizing alcohol, it also leads to increased frailty, causing higher risks of falling and likelihood of having a major injury if a fall occurs. Some research already finds that heavy alcohol use among older adults is associated with <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1532-5415.2004.52318.x">an increased risk of falls</a>. And falls are a real concern in later life – deaths from unintentional injuries are the seventh-leading cause of death among adults 65 and older, and <a href="https://www.cdc.gov/mmwr/volumes/67/wr/mm6718a1.htm">falls account for the largest percentage of those deaths</a>.</p>
<p>Compounding these issues is that many older people have multiple chronic health conditions that they are managing through prescription medications. Among older adults, <a href="https://www.nejm.org/doi/full/10.1056/NEJMsa1103053#t=letters">40 percent take five to nine different medications a day , and 18 percent take 10 or more</a>. Although there is growing awareness of the problems related to polypharmacy and there are efforts to decrease the number of medications older people take, there are a few common medications that have known interactions with alcohol, such as those commonly prescribed for blood pressure and arthritis. The toxicity of over-the-counter medications like aspirin <a href="https://journals.lww.com/co-clinicalnutrition/Fulltext/2008/01000/Age,_alcohol_metabolism_and_liver_disease.5.aspx">is also enhanced by alcohol</a>. This combination of factors gives us serious reasons to be cautious about how much we drink as we get older.</p>
<h2>Keep it at a drink or two a couple days a week</h2>
<p>So, should we be concerned if our older family members are having a glass of wine (or two) at that holiday party? Probably not – so long as that older person is not on any medications that interact with alcohol, is in good general health and has a designated driver. </p>
<p>But frequent, heavy alcohol consumption accelerates health decline at all stages of life. While most people know that heavy alcohol use leads to liver diseases like cirrhosis, alcohol is also a <a href="https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301199">major contributor to cancer mortality</a>. Having a couple of glasses of wine two to three days a week is probably not going to pose major problems for older people. But if those two glasses turn into four or five, regardless of your age, you are not only betting against your longevity, you are reducing the number of years that you are healthy enough to share a drink with your friends.</p><img src="https://counter.theconversation.com/content/106494/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Drinking among older adults is up. And while overdrinking may not pose an immediate threat of overdose, it is not healthy for seniors, many of whom take several medications and are at risk for falls.Amy Burdette, Associate Professor of Sociology, Florida State UniversityDawn Carr, Assistant Professor of Sociology, Florida State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1084942018-12-16T19:23:19Z2018-12-16T19:23:19ZChildren’s health hit for six as industry fails to regulate alcohol ads<figure><img src="https://images.theconversation.com/files/250586/original/file-20181214-178561-1lad053.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Alcohol ads can be broadcast during sports on weekends and public holidays. </span> <span class="attribution"><span class="source">from shutterstock.com</span></span></figcaption></figure><p>Australia is kicking off another summer of cricket. And if watching the series is a family affair, you may be concerned with the alcohol advertisements your children are being exposed to.</p>
<p>An extensive body of research shows exposure to alcohol advertising negatively impacts the drinking behaviours and attitudes of young people. Those who have greater exposure to alcohol marketing are <a href="https://onlinelibrary.wiley.com/doi/10.1111/add.13591">more likely to start drinking earlier, and binge drink</a>.</p>
<p>We <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.12872">assessed the potential impact of rules</a> introduced by the alcohol industry in November 2017 to regulate the placement of alcohol advertising. We found these rules have so far been unlikely to protect young people, while most complaints directed to the regulator have been dismissed.</p>
<p>In 2012, the now-defunct Australian National Preventive Health Agency (ANPHA) reviewed the effectiveness of alcohol advertising regulation. The <a href="http://www.alcohol.gov.au/internet/alcohol/publishing.nsf/Content/DCAD325BC0743EB3CA257EE0001AABAB/%24File/Alcohol%20Advertising%20Final%20Report%20April%202014.PDF">final report</a> was released <a href="https://theconversation.com/alcohol-advertising-has-no-place-on-our-kids-screens-49648">under Freedom of Information</a> laws in 2015. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/alcohol-advertising-has-no-place-on-our-kids-screens-49648">Alcohol advertising has no place on our kids' screens</a>
</strong>
</em>
</p>
<hr>
<p>Unfortunately, the review had little impact. The Australian government never formally released the final report nor responded to it.</p>
<p>Some state and territory governments, such as WA, have taken notice of the evidence and <a href="https://www.mediastatements.wa.gov.au/Pages/McGowan/2018/06/End-in-sight-for-alcohol-advertising-on-public-transport.aspx">removed alcohol ads</a> from public transport. But the Australian government must take action to protect children and young people’s health.</p>
<h2>How is the placement of alcohol advertising regulated?</h2>
<p>Before 2017, the industry-managed Alcohol Beverages Advertising Code (ABAC) Scheme did not cover the placement of alcohol ads. The only restrictions came from the <a href="http://oma.org.au/__data/assets/pdf_file/0019/6094/OMA_Alcohol_Guidelines_2013.pdf">Outdoor Media Association</a> (OMA) to limit alcohol ads on billboards or fixed signs to outside a 150 metre sight line of a school gate, and the Commercial Television Industry Code of Practice (CTICP). </p>
<p>The CTICP places some restrictions on when alcohol can be advertised on TV, but allows ads to be broadcast during sports on weekends and public holidays. </p>
<p>Previous <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/dar.12326">research found</a> high levels of exposure to alcohol advertising during televised sport in Australia. In 2012, children under 18 years received 51 million exposures via sport on TV. </p>
<p>In November 2017, the ABAC Scheme introduced what it called <a href="http://www.abac.org.au/wp-content/uploads/2017/07/ABAC_CodeofConduct_2017_web.pdf">“placement rules”</a>. They require alcohol marketers: </p>
<ul>
<li>comply with existing industry codes (such as the CTICP) regulating placement</li>
<li>use available age restriction controls to exclude minors from the audience </li>
<li>place alcohol ads only where the audience is reasonably expected to comprise at least 75% adults</li>
<li>do not place alcohol ads with programs or content primarily aimed at minors</li>
<li>do not send alcohol ads to a minor by email.</li>
</ul>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=406&fit=crop&dpr=1 600w, https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=406&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=406&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=510&fit=crop&dpr=1 754w, https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=510&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/250610/original/file-20181214-185255-qknto0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=510&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Children see many alcohol ads on television during sports coverage.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
</figcaption>
</figure>
<h2>Where do these rules fall short?</h2>
<p>The objective to “avoid the direction of alcohol marketing towards minors” is too narrow to be effective. It ignores the fact children are exposed to many alcohol ads that aren’t directed at them. Nor does it reflect recommendations from the <a href="https://www.who.int/ncds/management/best-buys/en/">World Health Organisation</a> for “comprehensive restrictions” on exposure to alcohol advertising.</p>
<p>The rules don’t cover key forms of marketing, including sponsorship, and they rely on weak existing industry codes. They do nothing to address the exemption in the CTICP, meaning alcohol ads are still allowed during sports broadcasts. </p>
<p>Our research found the panel dismissed complaints about children seeing alcohol ads during <a href="http://www.abac.org.au/wp-content/uploads/2017/12/121-17-Determination-21-12-17.pdf">test cricket</a> and <a href="http://www.abac.org.au/wp-content/uploads/2018/02/9-18-Determination-6-2-18.pdf">one-day matches</a>, and the <a href="http://www.abac.org.au/wp-content/uploads/2018/03/14-15-18-Determination-14-3-18.pdf">Australian Open tennis</a>. The panel decided the placement complied with the CTICP, the adult audience was over 75%, and the sports were not aimed at minors. </p>
<p>All but one of the 24 placement-related determinations published in the first six months of the rules were either dismissed or found to be “no fault” breaches.</p>
<p>Age restriction controls and an audience threshold of at least 75% adults do little to prevent alcohol ads from being placed where children will see them. Only 22% of the Australian population are aged <a href="http://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/communityprofile/036?opendocument">0-17 years</a>, so programs with broad appeal easily attract over 75% adults.</p>
<p>Further, there is a lack of transparency and independence in the system. There was no public consultation to inform the development of the placement rules and the alcohol industry is heavily involved in administering the scheme. There is no monitoring of alcohol marketing in Australia, and no penalties when companies breach the rules.</p>
<p>Our findings are in line with <a href="https://lr.law.qut.edu.au/article/view/738/651">recent research</a> from the University of Sydney that found significant weaknesses and limitations in the ABAC scheme system as a whole. </p>
<h2>What we need to do</h2>
<p>Self-regulation by industries such as alcohol or tobacco does little to reduce children’s exposure to marketing. We need government intervention if we want Australian kids to be protected from alcohol advertising.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/junk-food-advertisers-put-profits-before-childrens-health-and-we-let-them-51250">Junk food advertisers put profits before children’s health – and we let them</a>
</strong>
</em>
</p>
<hr>
<p>For starters, the federal government needs to remove the exemption in the CTICP and alcohol sponsorship of sport. This is the focus of <a href="http://www.endalcoholadvertisinginsport.org.au/">End Alcohol Advertising in Sport</a>, a campaign of sporting and community champions encouraging alcohol advertising to be phased out of professional sports. </p>
<p>The alcohol industry has demonstrated that they are unable to effectively control alcohol marketing. Statutory regulation by governments is the necessary step to ensure children’s exposure to alcohol advertising is minimised.</p><img src="https://counter.theconversation.com/content/108494/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The alcohol industry introduced rules to self-regulate placement of alcohol ads in November 2017. We reviewed the first six months of regulation and it was unlikely to protect young people.Julia Stafford, Research Fellow in Health Sciences, Curtin UniversityHannah Pierce, Research Associate, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1043132018-10-11T21:58:23Z2018-10-11T21:58:23ZTrauma 101 in the aftermath of the Ford-Kavanaugh saga<figure><img src="https://images.theconversation.com/files/240284/original/file-20181011-154583-mvnwbf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Christine Blasey Ford testifies before the Senate Judiciary Committee on Capitol Hill in Washington, D.C., on Sept. 27, 2018. </span> <span class="attribution"><span class="source">(AP Photo/Andrew Harnik, Pool)</span></span></figcaption></figure><p>Brett Kavanaugh is now a United States <a href="https://www.economist.com/the-economist-explains/2018/10/11/how-brett-kavanaugh-will-change-the-supreme-court">Supreme Court justice</a>. His contentious confirmation followed emotionally charged testimony to a U.S. Senate committee from the judge and Christine Blasey Ford after she came forward to allege <a href="http://time.com/5415027/christine-blasey-ford-testimony/">he’d sexually assaulted her</a> while they were in high school.</p>
<p>As the dust begins to settle, it’s important to remember everything we learned from the gripping events — in particular the causes and the impact of trauma. </p>
<p>Here are six of the biggest lessons on traumatology, or the scientific study of trauma, that were illuminated by the testimony of both Ford and Kavanaugh. </p>
<h2>Lesson 1: Trauma has a neurobiological footprint</h2>
<p>In a harrowing account of the assault, Ford described vivid imagery of Kavanaugh’s alleged behaviour. At other times, she <a href="https://www.cbc.ca/news/technology/memory-ford-kavanaugh-1.4842368">said she did not remember</a> all of the details. </p>
<p>This disparity in memory is due to <a href="https://www.ncbi.nlm.nih.gov/pubmed/16891563">the interaction of brain structures</a> known as the hippocampus (which stores our processed and time-stamped memories) and the amygdala (which stores emotional memories). Ford herself explained to senators how it worked:</p>
<blockquote>
<p>“Indelible in the hippocampus is the laughter, the uproarious laughter between the two. And their having fun at my expense.”</p>
</blockquote>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/HvqGCQkQbJs?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">ABC News.</span></figcaption>
</figure>
<p>Under extremely traumatic conditions, stress neurotransmitter levels become too overwhelming for the hippocampus, and prevent it from processing and storing sequential details. </p>
<p>However, the same processes increase sensory memory encoding in the amygdala, resulting in vivid traumatic memories. For this reason, Ford could recall certain aspects of her alleged assault in great detail and other aspects only vaguely.</p>
<h2>Lesson 2: Trauma is related to substance use</h2>
<p>The drinking mentioned in both Ford’s and Kavanaugh’s testimonies illustrate the gender differences in sexual assault victimization and perpetration, particularly when intoxicating substances are present.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/240280/original/file-20181011-154577-1ylmfjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/240280/original/file-20181011-154577-1ylmfjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/240280/original/file-20181011-154577-1ylmfjp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/240280/original/file-20181011-154577-1ylmfjp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/240280/original/file-20181011-154577-1ylmfjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/240280/original/file-20181011-154577-1ylmfjp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/240280/original/file-20181011-154577-1ylmfjp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Kavanaugh was unapologetic in the Senate hearings about his love of beer, then and now.</span>
<span class="attribution"><span class="source">Bence Boros/Unsplash</span></span>
</figcaption>
</figure>
<p>It’s been estimated that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484270/">more than half</a> of the sexual assaults on college campuses involve alcohol consumption by the victim, perpetrator or both. </p>
<p>Of course, as articulated by the U.S. National Institutes on Drug Abuse (NIDA), drinking does not cause sexual assault, but it is a “<a href="https://www.drugabuse.gov/sites/default/files/sexualassault.pdf">major contributing factor</a>.” Any serious initiative to curb sexual assault must also take a close look at binge-drinking culture. </p>
<h2>Lesson 3: Trauma causes blame, victimization</h2>
<p>NIDA notes that it’s imperative to end stigma and victim-blaming around assaults that involve alcohol. </p>
<p>Towards the end of her opening statement, Ford discussed the vile comments and threats hurled at her, and the victim-blaming she faced after coming forward. </p>
<p>This is a classic representation of “secondary victimization,” or the systematic re-traumatization of victims via behaviours of others that damage the recovery process and compromise psychological well-being. </p>
<p>Research has demonstrated that <a href="https://www.ncbi.nlm.nih.gov/pubmed/19014228">re-victimization perpetuates the psychological consequences</a> of trauma and also prevents victims from disclosing their trauma or seeking help. </p>
<h2>Lesson 4: Trauma extends to families, over time</h2>
<p>Both Ford and Kavanaugh are parents and spouses. Ford’s family is <a href="http://fortune.com/2018/10/08/christine-blasey-ford-still-facing-threats/">still receiving death threats</a>. <a href="https://www.usatoday.com/story/sports/columnist/erik-brady/2018/09/28/brett-kavanaugh-right-he-can-no-longer-coach-girls-basketball/1459496002/">Kavanaugh lamented</a> that he will no longer be able to coach his daughter’s sports team.</p>
<p>For victims and perpetrators, trauma produces a ripple effect that <a href="https://www.ncbi.nlm.nih.gov/pubmed/28549634">emanates across the family</a> and flows across generations. The research evidence in this area is also clear. </p>
<p>Children of parents who have experienced high levels of trauma are more likely to experience trauma themselves, largely due to family disruptions and stress. As is often the case, children are caught up in complex social tragedies that invariably infiltrate the family system. </p>
<h2>Lesson 5: Trauma often involves betrayal</h2>
<p>Before his confirmation, Kavanaugh was a circuit judge for the U.S. Court of Appeals in Washington, D.C. For many, seeing him further elevated to the highest court in the land represents a failure of the legislative process. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/240156/original/file-20181011-72133-yv11fp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/240156/original/file-20181011-72133-yv11fp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=373&fit=crop&dpr=1 600w, https://images.theconversation.com/files/240156/original/file-20181011-72133-yv11fp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=373&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/240156/original/file-20181011-72133-yv11fp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=373&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/240156/original/file-20181011-72133-yv11fp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=468&fit=crop&dpr=1 754w, https://images.theconversation.com/files/240156/original/file-20181011-72133-yv11fp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=468&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/240156/original/file-20181011-72133-yv11fp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=468&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Kavanaugh is sworn in as a Supreme Court justice in the White House on Oct. 8, 2018.</span>
<span class="attribution"><span class="source">(AP Photo/Susan Walsh)</span></span>
</figcaption>
</figure>
<p>This highlights two important ideas in traumatology. </p>
<p>The first is <em>betrayal trauma</em>, which occurs when a perpetrator is trusted by the victim — perhaps the accused is a sports coach, a local civil servant, a close friend or family member. </p>
<p>The second concept is <em>institutional betrayal</em>, whereby civic institutions systematically perpetuate the traumatization of a particular group. Examples here include the killing of young Black men by police, residential schools for First Nations children, and the historical treatment of women by male-dominated legislative bodies and by men in positions of authority. </p>
<h2>Lesson 6: Trauma hurts women, men differently</h2>
<p>This final point will surprise no one in the era of #MeToo.</p>
<p>Decades of research has demonstrated that, at the population level, <a href="https://www.ncbi.nlm.nih.gov/pubmed/17073529">women are more likely to meet diagnostic criteria</a> for post-traumatic stress disorder. They are more likely to be victims of sexual abuse and child abuse, and have higher levels of trauma symptoms in relation to any particular traumatic event. </p>
<p>That being said, this same research demonstrates that men are more likely to experience certain types of trauma, including accidents, non-sexual assaults, injury or death, from disasters or fires and combat or war. </p>
<p><a href="http://dx.doi.org/10.1192/bjp.179.6.482">Research on the idea of male “victim-perpetrators”</a> suggests that males who have experienced trauma (including child abuse), are more likely to perpetrate in later life. </p>
<p>The Ford-Kavanaugh saga clearly highlighted several lessons from traumatology and the complex consequences of traumatic events across society. </p>
<p>One final lesson, however, is that when dealing with trauma we must “speak the unspeakable,” raising our voices to have these difficult conversations. </p>
<p><a href="https://www.businessinsider.com/impeachement-brett-kavanaugh-democrats-republicans-trump-2018-9">Whatever happens in the months or years to come</a> to Justice Kavanaugh, Ford should be lauded for raising her voice. </p>
<p><em>Syeda Javeria Hasan, an undergraduate student in psychology at the University of Waterloo, co-authored this analysis.</em></p><img src="https://counter.theconversation.com/content/104313/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dillon Thomas Browne does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>If the Ford-Kavanaugh saga had any positive impact, it at least clearly highlighted several lessons from traumatology and the complex consequences of traumatic events across society.Dillon Thomas Browne, Assistant Professor, University of WaterlooLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1043602018-10-05T10:42:46Z2018-10-05T10:42:46Z‘Bystander effect’ and sexual assault: What the research says<p>Sexual assault, pushed into public conversation by the <a href="https://metoomvmt.org">#MeToo movement</a>, once again dominates the U.S. news cycle. Supreme Court nominee Brett Kavanaugh faces <a href="https://www.washingtonpost.com/politics/2018/09/27/brett-kavanaugh-allegations-sexual-misconduct-complete-list/?utm_term=.e2f508267f3e">allegations</a> that he sexually assaulted professor Christine Blasey Ford, a former high school classmate. </p>
<p>The allegations have led to a number of important questions regarding victim testimony, the veracity of memory and the justice system in America. </p>
<p>However, as social scientists who study sexuality and violence, we found ourselves asking a different question: Where were Kavanaugh and Ford’s classmates during this alleged incident? </p>
<h2>The role of bystanders</h2>
<p>Based on Dr. Ford’s testimony, party guests failed to notice this incident, let alone intervene to stop it. In fact, key witnesses have submitted affidavits stating that they did not see or that they have no recollection of the event. Whereas some politicians have used these affidavits <a href="https://www.washingtonpost.com/news/national/wp/2018/09/27/kavanaugh-hearing-transcript/?utm_term=.c4dbdcc321ba">to cast doubt</a> on Dr. Ford’s allegations, we believe these affidavits are in line with research concerning <a href="http://psycnet.apa.org/record/1968-08862-001">bystanders’ behavior</a> in potentially dangerous situations. </p>
<p>Over 50 years of research has documented a “<a href="http://psycnet.apa.org/buy/2011-08829-001">bystander effect</a>” in which witnesses fail to intervene in emergency situations, often because they assume someone else will take action. <a href="https://link.springer.com/article/10.1007/s11199-008-9581-5">Recent research</a> applying the bystander effect specifically to sexual assault
has revealed that witnesses fail to intervene for a number of common reasons: They fail to notice the assault; do not believe it is their responsibility to intervene; do not believe they have the skills to intervene; or are inhibited by the belief that those around them will negatively judge them for intervening. Witnesses to sexual assault often fail to intervene for one – or a combination of – these reasons. </p>
<p>Under mandate of the 2013 <a href="https://www.federalregister.gov/documents/2013/08/06/2013-18920/the-violence-against-women-reauthorization-act-of-2013-overview-of-applicability-to-hud-programs">United States Campus Sexual Violence Elimination (SaVE) Act</a> college campuses across the United States have begun implementing bystander training programs. These programs strive to sensitize young people to the warning signs of sexual assault, like a young man leading a young woman into an isolated place, and provide them with skills so that they will know how to intervene when necessary. For example, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/jcop.10078">these programs</a> might teach young people to walk a friend home when he or she has had too much to drink, start a conversation with a young woman who appears to be uncomfortable with her date, or call the police.</p>
<h2>Bystander training appears to help</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/239375/original/file-20181004-52660-xwaeme.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/239375/original/file-20181004-52660-xwaeme.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=438&fit=crop&dpr=1 600w, https://images.theconversation.com/files/239375/original/file-20181004-52660-xwaeme.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=438&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/239375/original/file-20181004-52660-xwaeme.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=438&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/239375/original/file-20181004-52660-xwaeme.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=550&fit=crop&dpr=1 754w, https://images.theconversation.com/files/239375/original/file-20181004-52660-xwaeme.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=550&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/239375/original/file-20181004-52660-xwaeme.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=550&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">After a night of drinking, it is important to not let one another walk home alone.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/three-beautiful-girls-bar-94587037?src=kLGD9T_hnETwjJAXnWBPkw-1-41">bokan/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>We were curious about the effects that these bystander programs have on the behavior of young people. So in a just-published study, <a href="https://link.springer.com/article/10.1007/s10964-018-0927-1">we analyzed data</a> from over 6,000 college students across the United States and found that programs designed to prevent sexual assault by increasing onlookers’ interventions do have a meaningful effect on bystander behavior. Compared to peers who did not participate in a bystander program, college students who did participate reported a greater ability to intervene and greater intentions to intervene, should a situation require it. </p>
<p>Most importantly, those who participated in a bystander program reported actually engaging in more bystander intervention behaviors than those who did not participate in a program. On average, these participants reported two more instances of bystander intervention in the months following the bystander program than their peers who did not attend a bystander program. Simply put, bystander programs are successful at encouraging bystanders to intervene when witnessing sexual assault or its warning signs. </p>
<p>These findings are especially important considering that <a href="http://journals.sagepub.com/doi/abs/10.1111/j.1471-6402.2005.00237.x?casa_token=DVSL8ImH6r8AAAAA:V8XWkSmOwwZEAPp6ieNHEPZ1GzcewkjdotzXUZY0dt8SE-CCyMFVqic5zSoU1_0-rwy6vm-Xq_U6">research</a> indicates that traditional sexual assault programs, which target the behavior of potential victims or of potential perpetrators, are not particularly effective at preventing assault. Thus, the power to prevent sexual assault may lie in the hands of bystanders. </p>
<p>The fact that allegations of sexual assault have entered into the process of appointing a Supreme Court justice reminds us that sexual assault affects us as a community and that its prevention is a communal responsibility. </p>
<p>As researchers who study sexuality, violence and prosocial behavior, we believe that bystanders need to keep their eyes open and speak up on behalf of potential victims. Our research demonstrates that having been educated about bystander strategies leads to greater intervention, which should lead to fewer sexual assaults. If a vigilant bystander noticed every time a young woman was led away to an isolated place at a party, then our world would be safer for all of us. We, as a society, should strive to become better bystanders by noticing the warning signs of a potential assault, knowing strategies to intervene, and remembering that we have a collective responsibility to prevent sexual assault.</p><img src="https://counter.theconversation.com/content/104360/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Hensman Kettrey received funding from The Campbell Collaboration to conduct the research reported here. </span></em></p><p class="fine-print"><em><span>Robert Marx does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Kavanaugh hearings have brought sexual assault to the forefront. A just-published study suggests that bystanders can help prevent it.Heather Hensman Kettrey, Assistant Professor of Sociology, Clemson UniversityRobert Marx, Ph.D. Student, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1040622018-10-03T04:31:23Z2018-10-03T04:31:23ZHazardous drinking: research finds that 40% of people over 50 drink too much<figure><img src="https://images.theconversation.com/files/238920/original/file-20181002-85623-b7bpzj.jpg?ixlib=rb-1.1.0&rect=287%2C278%2C5254%2C3700&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research shows that hazardous drinking is an issue for older people.</span> <span class="attribution"><span class="source">from www.shutterstock.com</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>Mention hazardous drinking and most of us imagine teenagers or students getting drunk, causing havoc and filling our emergency departments on a Friday night. </p>
<p>But what if I told you that we should be just as worried about how much our parents and grandparents are drinking?</p>
<p>Our <a href="https://www.hpa.org.nz/research-library/research-publications/prevalence-of-hazardous-drinking-in-older-new-zealanders">latest research</a> shows that up to 40% of adults aged 50 and over are hazardous drinkers. This increases to almost 50% for men in this age group.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/beer-bongs-and-baby-boomers-the-unlikely-tale-of-drug-and-alcohol-use-in-the-over-50s-82753">Beer, bongs and baby boomers: the unlikely tale of drug and alcohol use in the over 50s</a>
</strong>
</em>
</p>
<hr>
<h2>Alcohol-related risk for older adults</h2>
<p>Alcohol is the <a href="https://www.theguardian.com/society/2017/aug/23/baby-boomers-drink-and-drug-misuse-needs-urgent-action-warn-experts">drug of choice for baby boomers</a>. However, the older we get the lower the threshold for hazardous drinking is for two key reasons. First, ageing bodies can’t process alcohol as well as they used to so we get drunk faster and feel the effects more. Second, the older we get the more likely we are to have developed health conditions that alcohol exacerbates and to use medication that alcohol can interfere with.</p>
<p>Despite the heightened risks, we know older adults are less likely to be screened for alcohol than other groups. Further, when screening occurs, it usually ignores the combined health and medication risk factors that place older drinkers at such high risk.</p>
<p>Our research aimed to answer three simple questions: How many older adults are hazardous drinkers? Who is most at risk of harm? Where can we find them?</p>
<h2>Hazardous drinkers</h2>
<p>We used data from more than 4,000 New Zealanders aged 50 and over in the government-funded <a href="http://www.massey.ac.nz/massey/learning/departments/school-of-psychology/research/hart/new-zealand-health-work-and-retirement-study/new-zealand-health-work-and-retirement-study_home.cfm">Health, Work and Retirement study</a> at Massey University. We compared the number of hazardous drinkers identified on two different screening tests: a standard screening and one specific to older adults. </p>
<p>The <a href="https://www.hepatitis.va.gov/provider/tools/audit-c.asp#S1X">Alcohol Use Disorders Identification Test-Consumption</a> (AUDIT-C) is a standard screening for primary health care. It assesses how often you drink, how much you drink, and how often you binge (have six or more drinks). You are a hazardous drinker if your drinking pattern puts you at risk of harm immediately (weekly binge drinking) or in the long-term (frequent moderate drinking).</p>
<p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332987/">Comorbidity Alcohol Risk Evaluation Tool</a> (CARET) is a screening specific to alcohol-related harm for older adults. It assesses drinking patterns but modifies the allowable drinking frequency, quantity and binge limits based on the presence of health conditions and health issues that alcohol can make worse, and medication that alcohol can interfere with.</p>
<p>First, we found that 83% of older New Zealanders in this sample were current drinkers, while 13% were past drinkers who no longer drank, and 4% were lifetime abstainers.</p>
<p>Second, we found the CARET classified 35% of the sample as hazardous drinkers compared to 40% on the AUDIT-C. The higher proportion on the AUDIT-C resulted from our use of a stricter threshold for hazardous drinking than used on the CARET.</p>
<p>Approximately 10% of non-hazardous drinkers on the AUDIT-C were classed as hazardous on the CARET because despite their low levels of alcohol use their existing ill health and medication use made any drinking potentially harmful.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/maybe-moderate-drinking-isnt-so-good-for-you-after-all-72266">Maybe moderate drinking isn't so good for you after all</a>
</strong>
</em>
</p>
<hr>
<h2>Most at risk of harm</h2>
<p>We were able to identify key characteristics of older drinkers who were hazardous in both tests or one test only. </p>
<ul>
<li><p>Hazardous drinkers on both screens were predominantly healthy men who drank high amounts of alcohol very frequently, with monthly binge drinking</p></li>
<li><p>hazardous drinkers on AUDIT-C only were healthy men and women who drank small amounts of alcohol very frequently, with some binge drinking</p></li>
<li><p>hazardous drinkers on CARET only were unhealthy men and women who drank small amounts of alcohol frequently, with little or no binge drinking.</p></li>
</ul>
<p>This suggests GPs and practice nurses need to understand even older adults in good health require screening for their alcohol use, particularly older men. Further, any indication of very frequent drinking (five or more times a week) and binge drinking is a flag for concern. </p>
<p>Any older adults in poor health definitely require screening for alcohol use as any level of consumption may be dangerous. </p>
<h2>Where are the older hazardous drinkers</h2>
<p>For a GP or a practice nurse, older hazardous drinkers will be some of their most frequent patients. We found the majority of older hazardous drinkers saw their GP three or more times a year. Approximately 60% of drinkers whose ill health places them most at risk of harm actually visit their GP almost once a month.</p>
<p><a href="https://drinkwiseagewell.org.uk/time-called-time-ageism-alcohol-practice/">International research shows</a> health professionals are reluctant to talk to older adults about their drinking, older adults are less likely to be screened for alcohol use, and younger adults are prioritised for treatment. But the results of our study suggest the GPs office is the ideal setting to start this conversation about alcohol with older adults.</p><img src="https://counter.theconversation.com/content/104062/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andy Towers receives funding from the New Zealand Health Promotion Agency</span></em></p>Research shows that up to 40% of adults aged 50 and over are hazardous drinkers. For men in this age group this increases to almost 50%.Andy Towers, Senior Lecturer, School of Public Health, Massey UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1036212018-10-02T10:30:19Z2018-10-02T10:30:19ZInternational students on British drinking habits – ‘people don’t know when to stop’<figure><img src="https://images.theconversation.com/files/238672/original/file-20181001-195278-1ehvki.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>Of the <a href="https://www.universitiesuk.ac.uk/facts-and-stats/Pages/higher-education-data.aspx">2.3m students</a> starting courses at UK universities each autumn, well over 400,000 <a href="https://www.universitiesuk.ac.uk/policy-and-analysis/reports/Pages/international-facts-figures-2017.aspx">are international students</a> from non-UK countries. </p>
<p><a href="https://www.universitiesuk.ac.uk/facts-and-stats/Pages/higher-education-data.aspx">The scale and importance</a> of international students to the UK higher education sector is now well established. Yet we know very little about how students from non-UK countries experience and interact with the heavy drinking culture that predominates on and near many universities. </p>
<p>Many international students often come from cultures marked by moderation or abstinence around alcohol. And concerns have been raised that <a href="https://www.vice.com/en_uk/article/ne7e7m/international-students-on-what-shocked-them-most-about-british-uni">activities centred on alcohol</a> may exclude <a href="https://www.theguardian.com/education/2014/oct/13/-sp-meet-a-student-from-greece">international students</a>. </p>
<p>We’ve conducted <a href="https://doi.org/10.1177/1360780418761207">new research</a> to reveal the perceptions of British drinking cultures held by international students studying on postgraduate courses at a UK university. In focus groups and interviews, students from countries including Nigeria, the US, China, Turkey, Poland, Germany and Greece told us of their experiences of drinking culture at university. </p>
<h2>The British ‘like to drink’</h2>
<p>The <a href="https://study-uk.britishcouncil.org/living/culture-night-life">British Council</a>, and many city and university marketing teams, often promote the British pub as a safe and friendly leisure space in their bid to market studying in the UK to international students. The students we spoke to were aware of the iconic image of the British pub. They spoke of their desire to participate in what they saw as being an important part of British culture. Others spoke with excitement of being able to try British real ale and craft beer as a part of their experience of living and studying in Britain. </p>
<p>Having seen depictions of British pubs in television, film and, increasingly, social media, most international students were aware of alcohol consumption being important to British culture before they came to the UK. This prior perception was confirmed by their initial experiences on arrival. Our interviewees felt that getting drunk was an important part of British cultural life and reported being initially surprised that drinking to excess was <a href="https://www.tandfonline.com/doi/abs/10.1080/02614367.2011.633616">an expected part of university life</a>.</p>
<p>Despite these concerns, drinking alcohol was an important part of the social lives of many international students. Many had enjoyed their experiences of socialising in bars and pubs. For others, whose degree programme cohorts were predominantly fellow international students, the pub was a space in which they could view and interact with British culture and British people – such as non-student locals. </p>
<h2>Drinking cultures in contrast</h2>
<p>International students made ready comparisons with the drinking habits and attitudes of their own cultures. Many told us about how people drink alcohol and get drunk in their own cultures. But they contrasted this with the tendency of “going too far” and of “not knowing when to stop” that was perceived to be a major characteristic of British drinking culture. </p>
<p>That said, many interviewees had enjoyed learning about the practice of buying “rounds” of drinks, using “cheers” before drinking and the lack of table service in Britain. They saw this as a fun and a pleasurable part of getting to know local culture.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">International students say they are shocked at the amount of booze consumed by Brits at university.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>As identified in <a href="https://www.tandfonline.com/doi/abs/10.1080/08870446.2011.617444">other research</a>, gender is an important feature of how students view drinking and drunkenness. Concern was expressed in our study about a perceived lack of control among some British women when drinking alcohol. Words such as embarrassment and shame were used by both male and female interviewees to define the boundary between fun, sociable drinking and excessive drunkenness. </p>
<p>Interviewees expressed surprise that public vomiting and urination or collapsing in the street were so widely tolerated and even in some cases expected and celebrated by British students. </p>
<h2>Finding the balance</h2>
<p>Most students felt capable of negotiating their involvement with student drinking culture by choosing times, spaces and styles of drinking that suited their own tastes. This involved a clear preference for drinking as part of other events such as eating a meal out with friends or watching televised sport in pubs. At social events where heavy drinking was the main activity, some would try to enjoy “one or two” drinks but leave once other people became noticeably drunk.</p>
<p>But while many students spoke of the pub as a welcoming and relaxed space for socialising with friends, bars and nightclubs were said to be intimidating places where they felt at risk of violence or harassment. Many students witnessed fights. </p>
<p>Female international students had particular concerns – several spoke of their strategies to stay safe when out at night. The avoidance of the streets at night due to a fear of potential violence or aggression was also highlighted in a previous study that looked at levels of <a href="https://doi.org/10.1080/03075079.2011.614940">racism experienced by international students</a>.</p>
<p>That said, UK drinking culture is changing. More than a quarter of young adults in the UK <a href="https://www.theguardian.com/society/datablog/2017/may/06/more-than-a-quarter-of-young-adults-in-the-uk-do-not-drink-alcohol-in-data">do not drink alcohol</a>.
“Sober campuses” <a href="https://www.theguardian.com/commentisfree/2018/sep/27/students-british-booze-drinking-young-people">during fresher’s week</a> are becoming more prevalent, as are teetotal university halls. And many students are eager for advice on avoiding or moderating the <a href="https://theconversation.com/freshers-week-how-to-resist-the-pressure-to-drink-if-you-dont-want-to-103202?utm_source=twitter&utm_medium=twitterbutton">pressure to drink heavily while at university</a>. But only time will tell whether this is a trend that is set to remain.</p><img src="https://counter.theconversation.com/content/103621/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Public vomiting, urination and collapsing in the street are all things international students don’t see at home.Thomas Thurnell-Read, Lecturer in Cultural Sociology, Loughborough UniversityLorraine Brown, Associate Professor, Department of Tourism and Hospitality, Bournemouth UniversityPhilip Long, Honorary Visiting Research Associate, Bournemouth UniversityLicensed as Creative Commons – attribution, no derivatives.