Alcohol Policy and Research: "Lies, damned lies, and statistics"

by Bob Thompson
Nov 13 2008

author's note: This piece was written as a contribution to the public discussion of alcohol policy in Iowa City, Iowa. In November 2007, Iowa City voters shot down a ballot initiative to raise the bar entry age from 19 to 21 years of age. I was involved with two groups opposed to the measure, and reviewed a large body of research on the subject. In the fall of 2008, the Iowa City City Council and the University of Iowa began discussing potential strategies to alleviate Iowa City's ongoing problem with alcohol abuse. This piece distills some of what I have learned about this local issue, and the relevant scientific research.
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I'm writing about the City Council's current discussion of alcohol policy. Having researched the topic, I have some observations on why current strategies are not working, but also some good news: it may be possible to change things. Just not the way we're doing it. Unfortunately, with more than a decade of misinformation bombardment on the subject, I feel it's also necessary to explain the reasoning behind what has been advocated, and "deprogram" the reader by dissecting the philosophy and "science" of those alcohol policy experts who have dominated public discussion for the last decade. Yeah, you know who I'm talkin' about. Since I lack credentials or perhaps even respectability, I'll be providing links to all sources used for the basis of my arguments, so the reader can judge for themselves based on the evidence. Or not.

Every time I hear the words "research shows" in the context of alcohol policy, I cringe. As Bloc21's self-appointed research geek, I learned quite a bit about what the research really does show, and this differs considerably from what we've been told by some of our local alcohol policy experts. Statistics abuse is nearly as rampant as alcohol abuse in our society, but there are far fewer treatment options. What the "research shows" is that a lot of people in the health business have a social agenda, offer few if any proven or thoughtful solutions, make stuff up about research so it sounds like they have the answers, and no one fact-checks any of this, or even cares whether the information presented is accurate and useful.

It's hard to place much of the blame for such misinformation on our local alcohol policy enthusiasts, because it's too easy to trace all of their talking points back to large, well-funded organizations such as the AMA, RWJF, and NIAAA (pronounced NEEAAAH!). A new concept has taken hold in the realm of public health in dealing with alcohol, the "Environmental Management Model." The central doctrine of this faith is that restricting access to alcohol will result in lower consumption. First, the unspoken (and unsubstantiated) assumption upon which this theory stands is that access to alcohol can in fact be restricted in any meaningful way for the targeted group. Second, it requires a lopsided view of the law of supply and demand: supply does not exist in a vacuum, but responds to demand in intricate (or not-so-intricate) ways. When the supply spigot is shut off in one place, another will likely open up somewhere else. The most spectacular local example of this is the apparent effect of a dry UI campus on the proliferation of bars. A sharp increase in the number of downtown liquor licenses (1998: 33 licenses; 2005: 48 licenses) correlates with UI's ban on alcohol in dorms (2000), frats and sororities (1999). A bar owner told me that prior to the ban, it was impossible to compete with the massive frat parties, and UI's policy of prohibition was probably the best thing that ever happened to the bar business. Restricting access to bars, and reduction of the number of establishments, will likely result in a similar relocation of the party.

Any approach that emphasizes attacking the supply at the expense of less warlike tactics is likely to fail, as the most extreme example of National Prohibition should have shown us. During that period, there was a sudden decrease in consumption at the onset, but the black market eventually got up to speed. Some temperance nuts have attempted to spin National Prohibition as a public health success, but no direct measures of consumption are available for this period. When their simplistic analysis is deconstructed, it becomes apparent that it did not substantially diminish consumption in the long run, encouraged high-risk drinking, and was consistent with standard economic theory, which predicts that prohibition of any mutually beneficial exchange is doomed to fail.

Economic theory also predicts that a 21 ordinance might have the opposite of its intended effect. First, people tend to drink less when the per unit cost is higher; and it costs more per unit at a bar than at Hy Vee. When the unit price is a dollar, consumers will generally drink more than when paying 2 to 4 dollars at a bar. 21 advocates use the fact that price affects consumption in calling for price controls, but forget about it when advocating a higher bar entry age. Furthermore, consumers monitor their spending at a bar because alcohol is sold on a per unit basis, whereas "at a private residence, once alcohol is purchased and brought to the residence, the cost of the alcohol becomes a sunk cost and consumers are faced with zero per unit marginal cost of consumption... consumers respond to the zero marginal cost of consumption by increasing their consumption beyond what would be consumed at a drinking establishment with a positive per unit cost." Numbers obtained from the real world back this up: A study of Harvard CAS data shows substantially heavier student drinking at private parties, as opposed to bars. 21 advocates seem to take a grade school math approach to predicting a drop in consumption with reduced access to sources of alcohol; perhaps they even assume that when underage drinkers are refused access to a bar, they will simply walk down the street and have a root beer float instead. But "research shows" that 18-20-year-olds usually obtain alcohol through a legal age peer (68%). Restricting access at retail outlets is fine and dandy, but can it possibly help reduce consumption? More on this later.

MLDA and Scully

Advocates will insist that the Environmental Approach does in fact deal with the "demand" side of the equation, primarily in its call for increased enforcement and tougher penalties as a deterrent; make the consequences severe enough, and demand will be reduced. The evidence does not support this.

MECCA's Oct. 13 correspondence to the Council advocates enforcement of the minimum legal drinking age (MLDA) as one of a number of effective strategies. This basically looks like a reworded excerpt from the oft-cited "A Call to Action," an NIAAA publication provided to college presidents. MECCA doesn't cite sources for this argument, but the NIAAA does. One of the sources is particularly interesting, as it illustrates how the conclusions of such studies often differ radically with how they are interpreted by people seeking to justify a particular agenda.

First, it's vital to note the organizational structure of the NIAAA's recommended strategies. "Tier 1" strategies are the only ones known to be effective on college students (according to the NIAAA, that is). All of the Tier 1 strategies target individual problem, at-risk, or alcohol-dependent drinkers; individuals, not whole environments. NIAAA further cautions against making too much of even these, the top-tier, proven strategies: "Their efficacy as part of a campus-wide strategy has not been tested." Here's what this means: At the time of that writing (April 2002), no "environmental" strategies were known to work for college students. Period. Not much has changed since then; but I'm saving the good news for the end.

Enforcement of the MLDA is a Tier 2 strategy, meaning it has "not yet been comprehensively evaluated with college students" --although one of the sources cited did evaluate the effectiveness of the MLDA itself:
"Of 24 college-specific analyses, 3 (13%) found a significant inverse relationship between the legal age and alcohol consumption, 3 found a significant positive relationship, and 15 found no significant relationship. One additional study found an inverse relationship with no report on significance levels."
Given their extensive relationship with Neo-Prohibitionist organizations, these researchers might fairly be called Neo-Prohibitionists themselves; yet the most positive thing they could say was that "existing research clearly does not suggest that the age-21 MLDA has increased problems among college students." That's right: for college students, it has had no significant effect on consumption whatsoever! Others have dealt with the massive statistical fraud supporting the 21 MLDA, including alcohol researcher Dr. David J. Hanson, with whom I corresponded during the 21 ordinance campaign. A prolific contributor to alcohol policy debate, Hanson runs the popular website "Alcohol Problems and Solutions." He offers a rebuttal of the NIAAA's rebuttal of common arguments for lowering the MLDA (kindly provided to the Council by MECCA). Of the largest statistical malfeasance used to support a 21 drinking age, he writes:
It’s true that lower rates of alcohol-related traffic accidents now occur among drivers under the age of 21. But they’ve also been declining among those age 21 and older, with one notable exception.

Raising the minimum legal drinking age has resulted in an apparent displacement of large numbers of alcohol-related traffic fatalities from those under the age of 21 to those age 21 to 24. In short, raising the drinking age simply changed the ages of those killed.
Many other factors likely contributed to the general decline of traffic fatalities: Safer vehicles, increased use of seat belts, changing attitudes toward drinking and driving, etc. The decline in drunk driving fatalities for age groups 16-20 and 21-24 also seems to follow the change in population of those age groups. For the same period, the NHTSA found that "Canadian reductions in youth drinking and driving, measured both by fatal crash data and by surveys, followed virtually the same pattern as in the United States. But the Canadian reduction was not due to laws directed at youth: the drinking age did not change during this time and zero tolerance laws were implemented after the reduction had occurred. This means that the changes must have resulted from some combination of the difficult-to-assess educational and motivational programs and from other factors outside of traffic safety. This suggests that a substantial portion of the reduction in the United States also resulted from these same causes." There are too many other reasonable explanations for the decline to attribute it to the drinking age. In the war against alcohol, truth is the first casualty.

A must-read is Hanson's article on how the alcohol policy debate's dominant voices "lie" with statistics, and use various other deceptive tactics. His article "A Junk Science Congregation" gives a real life example, in this case of how a group of supposedly intelligent people converged on a government inquiry into the effects of alcohol advertising, and turned it into something resembling a tent revival meeting. The truth about advertising restrictions? "Research from around the world has repeatedly demonstrated for decades that alcohol advertising doesn't increase overall consumption, doesn't contribute to alcohol abuse, and doesn't cause non-drinkers to become drinkers. However, what it has found is that successful advertisers increase their market share at the expense of their competitors, who lose market share."

Hanson and Dr. Ruth Engs studied the immediate effect of raising the drinking age, and concluded that "the legislation may actually have contributed to increased drinking among underage students through the arousal of reactance motivation." Reactance motivation is a tendency to rebel to regain control over lost freedoms, such as being able to drink legally. The problem with a 21 MLDA, and a possible solution, is discussed here, with a tidy summary of the problem: "Should anyone be surprised that zero tolerance is met with rebellion and rule breaking? Outlandish behavior is a typical reaction to prohibition, which is why the illegal speakeasies were always bawdier than the public bars that the Volstead Act shut down. The modern age-based prohibition seems to be working no better than the 1920s version; while a smaller percentage of young adults are now drinking, a sizable minority is drinking recklessly."

But the "environmental" strategy specifically calls for greater enforcement of the MLDA. What does the NIAAA say about that? "Increased enforcement—specifically compliance checks on retail alcohol outlets—typically cuts rates of sales to minors by at least half." Yes, "compliance checks on retail alcohol outlets" is the only enforcement strategy known to have an effect; and it is not known to have an effect on consumption, but only on "rates of sales to minors." (My theory is that it does indeed have an effect on consumption -- for about 10 minutes, the time it takes to walk back to the house party.) The Harvard drinking surveys of UI students show that "binge drinking" and related harms continue to increase, unaffected by increased enforcement efforts, higher PAULA fines, etc. College students have no problem obtaining alcohol from legal age peers, and compliance checks are only known to have the effect of increasing compliance by retail alcohol outlets -- not on the goal of reducing excessive consumption. Changing the location of the spigot again. Well, that's not the goal, but I guess it's something, ain't it.

Heavy-handed enforcement may sometimes have unintended negative consequences; the least favorite consequence for law enforcement is probably the ensuing public relations nightmares. In an investigation into the infamous VEISHEA riots, the task force noted that 3 of ISU's last 4 "celebratory disturbances" were likely sparked by police intervention, and wrote:
"...(P)olicies that restrict alcohol may lead to rioting by (1) driving drinking into large off-campus parties and (2) creating encounters between partiers and police attempting to enforce alcohol restrictions or respond to problems created by drinking. Buettner (2004) suggests that the emergence and spread of the mixed-issue campus disturbance may be connected to the raising of the drinking age in the mid-1980s to comply with a federal mandate... The more restrictive drinking rules resulted in movement of drinking to large, unregulated off-campus parties and created the possibility of more frequent hostile encounters with police...

"In addition to the federally-mandated drinking age, Iowa State University students face a number of restrictions on alcohol consumption, such as:
The higher MLDA does seem to have reduced drinking among high school students, probably owing to the fact that they have far fewer legal age drinking buddies than do college undergrads. But advocates use statistics taken from wider samples and different social environments than could legitimately be used as evidence that greater enforcement could have a beneficial effect on college environments. So many statistical abuses come to mind at this point, I could write a book (which I'm not); the worst abuse I've seen came from Citizens for Healthy Choices, the group that put the 21 ordinance on the ballot last year. The impetus for my research binge was my discovery that they fabricated research statements, substituting the words "legal-age bar entry ordinance" for "minimum legal drinking age" in summaries of research copied from AMA and NIAAA documents. UI's most prominent and respected alcohol researcher ran around town proclaiming that the ordinance would reduce underage consumption by 25-30%, yet there is no research on the efficacy of such an ordinance. Such heartfelt respect for scientific accuracy should never go unrewarded. The weakness of their position is obvious. Why is anyone still listening to these guys?

AMODern Authoritarian Approach

"Well, these things take time," they say. Stepping Up points out that "it took decades to change the culture about smoking in public places. Likewise, it will take time to reduce the harms that excessive drinkers and their suppliers cause for other people." Great, so we have to listen to this for centuries. The high priests of the Environmental Management Model are now basically saying that only a multitude of restrictions, crackdowns and penalties heaped together in a massive, never-ending anti-alcohol campaign can even begin to curb the drinking. Um, how do they know this?

Maybe from the 2004 evaluation of the "A Matter of Degree Program" (AMOD), of which our local Stepping Up Project is a part. In the introduction, we find a terse summary of the basic tenets of the faith:
Emerging evidence indicates the importance of environmental determinants of heavy alcohol use, and suggests a broader selection of prevention strategies for addressing college student drinking. Effective program models might combine individually focused strategies with ones that address the environment, such as enforcement of minimum drinking age laws; limiting access to low-cost, high-volume drink specials, advertising of alcohol to youth, the proliferation of alcohol outlets; and instituting responsible beverage service training. These approaches are effective prevention measures when implemented in the general population and are recommended for addressing college student drinking.
Most of the problem with enforcing a 21 MLDA in a college community stems from the fact that underage students are placed in a unique social context with those of legal age. Can a college student's social environment compare to that of the "general population"? How "general" can we get when comparing apples to oranges?  The authors of the 2004 evaluation cite "A Call to Action" as a scholarly source supporting the quote above, specifically the document's Tier 2 strategies (not known to be effective on college students). This is where we discover just how weak the supporting research really is for what is being advocated. In its justification for "Restrictions on alcohol retail outlet density," the NIAAA can show a correlation between greater alcohol outlet density and greater problems, but can't predict that fewer problems will result from lower density:
Studies of the number of alcohol licenses or outlets per population size have found a relationship between the density of alcohol outlets, consumption, and related problems such as violence, other crime, and health problems (Toomey and Wagenaar, 2002). One study, targeting college students specifically, found higher levels of drinking and binge drinking among underage and older college students when a larger number of businesses sold alcohol within one mile of campus (Chaloupka and Wechsler, 1996). Numbers of outlets may be restricted directly or indirectly through policies that make licenses more difficult to obtain such as increasing the cost of a license.
Correlation does not prove causation; or as Hanson put it, "stork sightings have been highly correlated with births and skirt heights have been correlated with the height of the stock market." This is more complex than that, but not much: The observation of correlation in no way implies that a reduction in alcohol outlets would result in a reduction in alcohol-related problems, absent a drop in demand. This is because it cannot prove that alternative (and perhaps cheaper) sources of alcohol could not be found and utilized (and found easily!). So they have no idea what would happen if someone found a way to systematically shut bars down, and otherwise measurably reduce access. But if someone tried, they'd sure like to study the results. Well someone tried that for them: The ten AMOD coalitions, including Stepping Up.

NIAAA's justification for "increased prices and excise taxes on alcoholic beverages" isn't encouraging either. Though price has some effect for the general population, "Chaloupka and Wechsler (1996) found that higher beer prices tend to decrease drinking and binge drinking among U.S. college students, but that price is a relatively weak tool for influencing these behaviors among college students, especially males."

And how weak a tool is "responsible beverage service policies"? "Studies suggest that bartenders, waiters, and others in the hospitality industry would welcome written policies about responsible service of alcohol and training in how to implement them appropriately." Are you freakin' kidding me. Studies suggest that bartenders would welcome written policies about responsible service. Sure, especially if it's the cops suggesting it. What bar were the researchers "studying" in when they discovered this? I can suggest something too: Go downtown and ask, "Hey bartender, would you welcome written policies about responsible service of alcohol and training in how to implement them appropriately?" Let me know how that turns out. Nothing at all wrong with responsible bartenders, but also nothing here about studies suggesting this might put a dent in the problem; all they have is "studies suggest that bartenders would welcome" it. Now THAT's science. But what the hell, what's one more ordinance.

Back to the 2004 AMOD evaluation. "While there was no change in the ten AMOD schools in study measures, significant although small improvements in alcohol consumption and related harms at colleges were observed among students at the five AMOD sites that most closely implemented the environmental model." So they threw out the data for half the test sites, including Iowa City, in order to barely achieve statistically significant change. And looking at the tables, I don't see how this could be viewed as anything resembling significant improvement. How encouraging.

So, it seems we've been presented with two options here: We can deploy a massive crackdown forever and achieve barely significant results, or do nothing. Is there anything that actually works?

Nebraska??!

Toward the end of the 21 ordinance campaign, I started looking into alternative solutions. Unfortunately, it took so much time to investigate the flawed arguments of our opponents, I was sick of the topic by then, and didn't have the time or energy to do the inquiry justice. Finding successful examples to follow seemed like looking for a needle in a haystack. And where better to find a haystack than Nebraska?

One of the AMOD sites, the University of Nebraska-Lincoln, did manage to put a dent in their drinking problem; comparing the results they achieved in five years with the tables presented in the AMOD evaluation makes me wonder just how much the results for the five "successful" programs got pumped up solely by UNL's contribution. I was under the impression that the final AMOD evaluation was due earlier this year, but it has yet to appear. Maybe the program was such a flop they were afraid to publish the results; but it was up to the individual AMOD coalitions whether they wanted to release the local results of student drinking surveys. Most of the coalitions kept their mouths shut about it, but UNL showed theirs, and they are the only example of success I could find. Stepping Up also released the results of UI student surveys, if you're looking for an example of miserable failure. UNL showed significant declines in drinking and related harms in all respects but the most alarming one: the percentage of students drinking after driving doubled from 2003 (23%) to 2006 (46%). I'm not investigating this, but it probably had a lot to do with all the crackdowns in close proximity to campus. In my opinion, this side effect is simply unacceptable.

With that profoundly negative consequence in mind, a careful look at the closest thing resembling "success" is in order. In a 2006 article, UNL's assistant director of student involvement Tom Workman said, "We looked at what worked and what didn't work, and the bottom line was that the only answer was everything. It took 360-degree coverage by the full community to impact that." In other words, an all-out crusade. That's wonderful.

We had what seemed like an all-out crusade in Iowa City too, complete with lots of ordinances, dramatic spikes in drug and alcohol related arrests far greater than any other jurisdiction in Iowa, doctors with PowerPoint presentations scaring little old ladies in church basements, the whole deal. If there's anything we've had plenty of, it's anti-alcohol hype and crackdowns. Yet drinking continued to increase, as if it were occurring in a parallel universe. What was different in Nebraska?

Let me preface my analysis with a couple of caveats. First, I'm not claiming any right as a spokesman or analyst for UNL's program. Critics of Iowa City's efforts fall short if they offer nothing in the way of alternative approaches, and gosh I'm sorry, but this is the best I could do. I'm not in charge of anything around here, I'm only trying to point things in a less hopeless direction. Second, full disclosure: If you haven't guessed this yet, I'm not a fan of this "environmental management" stuff. I find it elitist, demeaning, condescending, and authoritarian. It also appears to be ineffective, even at UNL. I cite UNL's example against my own inclinations, because they did not reject the Environmental Management Model; but what they did with it was far more diverse and creative than our local efforts, and actually went well outside the boundaries of any "environmental management" advice offered by their handlers at the AMA. In fact, in some respects it appears that the Lincoln coalition mutinied against the AMOD agenda, at one point incurring enough of the AMA's wrath that AMOD Advocacy Initiative advisors were pulled out of the program. Their crime?

NU Directions worked with drinking establishments, rather than declaring war on them

According to their Five Year Report, NU Directions rewrote their policy goals to "reflect a change from the reduction and/or control of density to the management of density. The refocused goal identified the management of problematic establishments as a strategy toward reducing problems associated with density without addressing density specifically. Given this change, the AMOD Program office, NU Directions staff, and Pan American consultants agreed to suspend the technical assistance of Pan American Services in Lincoln." They decided to deal with problems with the rowdier bars rather than try to put bars out of business to reduce outlet density. Heresy! Remember, AMOD wanted to see what would happen if a bunch of bars got shut down. And think about what might be at stake politically, from the perspective of the Neo-Prohibitionists: If they could somehow show that a reduction of outlet density caused a drop in drinking, they would use this to promote local, state-level, maybe even federal legislation to force bars out of business. Carrie Nation goes to Washington. What, you think they wouldn't do that?

NU Directions looked into zoning as a tool for "managing the retail environment," which is Neo-Prohibitionist for "putting bars out of business." They hosted "bar walks" and all sorts of stunts to "educate" civic leaders on the need to shut down a bunch of bars, pretty much the same as here. They even had a "symposium." Frankly, I'm not sure what a "symposium" is, but they had one. Important sounding word, symposium. The result of all this brainstorming was that they focused on "creating better alcohol service in Lincoln," and stopped the all-out war against outlet density, greatly displeasing their masters.

NU Directions did more than just crack down on problem bars: They also offered a positive incentive for good behavior. They started a website, nutodo.com, in which local drinking establishments could advertise if they signed a "Responsible Business Agreement." Not sure how that worked out, but it's a good idea in theory. Nutodo.com now redirects to UNLlife.com. No signs of any life there, so I assume the program was discontinued. For such a promotional incentive to be successful, it would have to reach a wide audience. It seems wise from a psychological perspective to offer positive incentives for good behavior; or at least something more positive than "obey, or we crush you." Unfortunately, this is the prevailing message conveyed by the crackdown mentality that's largely driven our local effort.

NU Directions developed realistic goals, and was responsive to public perception

Unlike local advocates, Lincoln's coalition was not oblivious or indifferent to public criticism, but rightly viewed negative public perception as a serious impediment to change:
Focus group and survey data suggests that many UNL students perceived the efforts of NU Directions as prohibition rather than harm reduction, and that the overall message of the coalition as “Drinking is bad. Don’t drink.” Expecting this reaction, the Education and Information Workgroup focused its initial efforts on developing a clear and concise definition of high-risk drinking, communicating it in billboard and campus newspaper advertisements, campus and community presentations, the coalition web site, and all coalition materials (Objective 11.1). High-risk drinking was defined as consumption that increased the likelihood of negative physical, legal, personal or academic consequences.
Unfortunately, they also had a "zero tolerance" message for underage drinkers. This is simply unrealistic, but will probably never go away until MLDA laws receive substantial repair. Yet UNL was not afraid to show as a measure of success a significant increase in the number of students who reported drinking but not "bingeing." Feigning outrage that there are 18-20 year olds drinking in a college town is just silly. Most people would be ecstatic if we could just convince them to turn it down a couple of notches.

NU Directions deployed a comprehensive Social Norms campaign

If I understand Social Norms Theory correctly, the worst thing that could be done is exactly what happened here: Ranting and raving about what a bunch of stinking drunks all those gosh darn college students are. Social Norms Marketing seeks to correct erroneous perceptions reinforcing drunkenness as normative behavior. "Social norming" is listed by the NIAAA in its "Tier 3" strategies (Evidence of Logical and Theoretical Promise), advising that "schools to assemble a team of experienced researchers to assist them in the process." It's a bit trickier than brute force, requiring accurate surveys and effective marketing. It has received some media attention, but unlike RWJF-funded programs, does not have a multi-million dollar promotional budget. As USA Today reported, "The key is to not over-report the incidences of dangerous drinking that occur, and to broadly promote the general good health of students so that it is perceived as normal not to drink." --Or to be more realistic, that it is perceived as normal to drink moderately, which is simply the truth. Iowa City is probably a textbook example of precisely the opposite, in which media and anti-alcohol crusaders continuously portray students as wild, drunken animals. If there is a method to such madness, it would seem to involve cultivating an atmosphere of hysteria to garner public support for policy objectives. This is destructive, divisive, and stupid. Some of these people can't mention the subject without using the word "vomit." So much for intelligent debate.

The Higher Education Center is another entity promoting the Environmental Management Model, but much as they'd love to be able to say that it actually works in this document, they can't cite any successes for any approach except Social Norms Marketing. "Once students’ misperceptions of the norm are corrected, drinking levels on campus appear to go down by about 20%." HEC gives a few examples:

    Hobart/William Smith Colleges: high risk drinking was reduced by 21%
    University of Arizona: high risk drinking was reduced by 21%
    Western Washington University: high risk drinking was reduced by 20%
    Northern Illinois University: high risk drinking was reduced by 18%

Actually, NIU reportedly had a 44% reduction between 1990 and 1999. Other reports claim that Hobart/William Smith achieved a 32% reduction over 4 years, Arizona 27%, and Rowan University 25%. Given these models of successful campaigns, one can legitimately suspect that UNL's carefully designed, very comprehensive Social Norms campaign may be the reason for their success, rather than any of the "environmental" stuff. Social Norms Marketing only works if a misperception in drinking norms exists; the social environment determines the potential for effectiveness.

Incidently, the HEC also gives us the real reason why all this is going on: "Colleges are being held increasingly accountable in cases where students drink alcohol and cause injury or damage to themselves or others. These legal changes move towards a shared (vs. individual) responsibility for alcohol risks in the college environment, and increased legal responsibility of the college to create a more responsible alcohol culture." Oh yeah, money. I forgot, that's the only reason anyone ever does anything. Apparently there is now some legal precedent for holding colleges liable for damages, presumably due to negligence in controlling their students. This must be why the University of Iowa's first real move was to push all the drinking off campus, hmmm? It might look more like they were responsibly addressing the problem if they tried something that actually worked.

Stepping Up might respond that they did in fact have a social norms campaign --but this consisted of a short-lived, low-budget goofy ad campaign. Social Norms advocates say that the truthfulness, scope and creative integrity of the campaign matters a lot, and requires considerable expertise. You can't just put posters up in the dorms, and call it a legitimate campaign. Henry Wechsler of the Harvard College Alcohol Study is one of the leading advocates of the environmental approach. He attempted to discredit Social Norms by publishing a "study" that failed to define what a legitimate social norms campaign is, but merely asked administrators if they'd ever had one. There seems to be a large academic rift between those who favor Environmental Management and those who do not. The lavish funding for promoting this Neo-Prohibitionist agenda has all but drowned out the opposition in recent years, but it has yet to produce any evidence of success.

NU Directions used individual and small group interventions known to be effective

From their Five Year Report:
The Education & Information Workgroup focused on brief motivational feedback programs in a variety of formats, including group classes of the Alcohol Skills Training Program (ASTP) for students who violated community laws and campus alcohol policies (Objective 2.1), with one-on-one sessions of the Brief Alcohol Screening and Intervention for College Students (BASICS) for repeat offenders or those unable to attend scheduled classes... In addition to brief motivational feedback programming, identified high-risk populations received a variety of targeted campaigns and activities. An NCAA grant linked athletes with peer educators in a program called Husker Choices. Athletic teams and other high risk populations received peer-led presentations along with motivational feedback programming. A series of focus groups were conducted with first-year female students and their resident advisors to better inform efforts directed at this group of students.
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In summary, UNL went far beyond the limited scope of "environmental management" tactics, deploying a bewildering array of programs, some of which actually have a proven track record. They exhaustively researched and planned all their activities. They had vigorous, creative leadership. They heavily recruited students to participate, and showed respect for students. They displayed intelligence and integrity. In short, they put Iowa City's efforts to shame. While Iowa City focused almost entirely on changing behavior by force, others have achieved positive results with intelligent, researched, carefully orchestrated programs.

During the 21 campaign, Iowa City was an object of some nationwide scrutiny. Dr. Hanson shared an observation from one of his colleagues:
Let me see if I get this right.

Ames, Iowa bans under-21 year old young adult Iowa State University Students from bars and night clubs, has keg registration, a nuisance party ordinance, etc., and the result is 198 citations in 2006 for underage violations. vs 1,286 citations in Iowa City that's trying to get an under-21 ordinance passed this year.

Is this what FHE-ASAP and the Florida Coalition on Alcohol Policy  wants in all Florida higher ed communities?

Here's what I think.

About 75-80% of Iowa State young adults 18-20 drink and 198 got caught. Of those that drink, 85% do so responsibly and about 15% probably  fall into the "high-risk" drinking category.  (The same could be said for every college and university in the nation, except for Brigham Young) The Ames police department could write 198 citations a week if they were so inclined.  Instead, the 18-20 year old young adults are forced underground or out to the Ames, Iowa corn fields to party and socialize. Some drive the 90 miles to Iowa City, where the 18-20 year-olds with their fake IDs go to party, socialize and dance, then drive the 90 miles back to Ames at 1, 2, 3, 4, 5, or so AM, after their responsible drinking has got their BACs below the .08 legal limit...or .02 for underage.  A dean of students utopia!

Of course, when Iowa City, Iowa bans 18-20 year old young adults, the world will be perfect for Iowa...they'll all be out in the corn fields partying. Because there is keg registration, the 21-year old buddy goes into the State liquor store, purchases a 1.75 liter bottle of whatever liquor...which contains about the same alcohol by volume as a 32 or so gallon keg of beer...and they do liquor shots instead...because we know they can get a buzz much faster with shots than red cups of beer. A dean of students nightmare!

I don't recall a president, vice president of student affairs, or dean of students of either of these universities giving a presentation to the higher ed national meeting in the last 8 years I attended.  No poster sessions saying we've cut underage and high risk drinking by X% in the 28 years or so the policies have been on the books in Ames, for example...nothing of the sort.  Yet, this is what the AMOD sites were supposed to emulate.

Einstein is often credited with the definition of insanity -- doing the same thing over and over and expecting different results.  Is there a cure for the form of insanity we seem to be trying to perpetuate above?

Perhaps, just perhaps, you should invite Dr. John McCardell, Dr. David Hanson, and Dr.Bill DeJong on one of our monthly teleconferences for a discussion on  finding better ways to deal with Einstein's definition.  It's time for more thoughtful discourse.  I don't think nor believe Iowa has found underage/high risk drinking utopia after almost 3 decades of struggling.
Well, at least we're capable of serving as a bad example. Here's what I think: We aren't really dealing with the root of the problem at all. Outlet density, drunkenness as normal behavior, and other evils condemned by Neo-Prohibitionists are not causes of the problem, they are symptoms. Alcohol abuse, and a social structure revolving around alcohol abuse, is an indicator of a deeper problem. We are dancing around a larger issue. Frankly, I think the crackdown approach has been given more than a fair shot. Law enforcement is stretched thin, yet more laws are being contemplated. Shall we continue to do more of the same, and expect different results? The problem is bigger than the scope and power of government.

One important study found that schools with a high level of social capital have lower levels of high risk drinking, using volunteerism as a measure of social capital. "Social capital is a contextual characteristic describing patterns of civic engagement, trust, and mutual obligation among persons." The study "sought to examine campus-level patterns of participation in voluntary activities (an indicator of social capital) in relation to binge drinking in college. Campuses with high levels of social capital may provide the patterns of interconnectedness and mutual obligation required for collective regulation of deviancy in a group. Although social capital may have little effect on (or even encourage) light drinking, it may protect against binge and problem drinking... The findings encourage us to include as prevention programs initiatives aiming to change the social fabric of a college community. The findings also underscore the importance of looking more deeply at how context determines drinking risks and thus may add to the national debate on preventing highrisk drinking. This debate may be polarizing around norm-shifting and supply-reducing approaches. A broader, more integrated view may be needed."

No kidding.

Though the UI probably isn't aware that efforts to build social capital might also help curb drinking, its Civic Engagement and Pick One! programs are steps in a good direction. If you haven't noticed, our society is in a decline, with much lower levels of social capital and higher levels of isolation and fragmentation than was the case decades ago. In the long run, finding ways to promote greater social capital might help build a more robust, "healthy" environment producing individuals with less inclination to get dangerously drunk and cause problems. If the greatest sense of belonging offered to young people involves beer bongs and couch burnings, we're in trouble.