FOOTNOTES
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Public Forum

Binge Drinking Prevention Research
We appreciate the space Footnotes devoted in the December 2002 issue to the important topic of binge drinking among college students (“Sociological Approaches Hold Promise to Curb Campus Drinking”). The nature and extent of the problem have been well documented. But one important question remains: What can be done about it? The foundations to that answer are solid theory, measurement, and data.

The Harvard School of Public Health College Alcohol Study (www.hsph.harvard.edu/cas) is guided by a preventive medicine framework that draws on theory from multiple disciplines, including sociology, economics, psychology, and public policy. It is widely used in public health, and has led to successful interventions in a range of health-related problems, including alcohol.

The prevention approaches that we have encouraged colleges to pursue are based on theory and supported by peer-reviewed studies in academic journals. The social-norms marketing approach so favorably presented in the article has a weak theoretical basis that is isolated from other theory and has little empirical support.

This approach has caught the attention of people in higher education, mostly through promotion in non-academic publications, conferences, and on the Internet—all of which foster the notion that it is effective. Some of this promotion has been initiated and supported by the alcohol industry. An approach based on the premise that there are fewer alcohol problems than people think, and that promotes drinking as a normal behavior among college students, is bound to appeal to the industry.

We encourage scientists and college administrators to engage in a careful examination of the evidence. Thus far, few social-norms marketing campaigns have been formally evaluated. The handful of published evaluations that exist has serious methodological flaws. If something sounds too good to be true, it usually is.

Henry Wechsler (hwechsle@hsph.harvard. edu) and Toben F. Nelson (tnelson@hsph.harvard.edu), Harvard School of Public Health

Student Drinking: Reply to Wechsler and Nelson
Henry Wechsler’s and Toben Nelson’s response to the December 2002 Footnotes article on sociological approaches to curbing campus drinking simply repeats Wechsler’s now familiar but unsubstantiated criticism of social norms research and interventions. I agree that high-risk drinking in college is a serious problem and that the important question is how to reduce it based on theory, measurement, and data—precisely the question addressed by the social norms approach. Wechsler’s and Nelson’s disparaging remarks exhibit an inexplicable lack of knowledge about social norms theory and its associated published research base.

First, they suggest the approach is “isolated from other theory” in social science. What could be any more grounded in a fundamental sociological perspective than work on norms affecting human behavior and the power of peer influence? What could be more in line with classic sociological tradition than pointing out our often inaccurate perceptions of what is normative, and how those perceptions of what is real, become real in their consequences (W.I. Thomas) as a partially self-fulfilling prophecy (Robert Merton)? Indeed, social norms theory argues that the overestimated incidence of risky behaviors and exaggerated perceptions of permissive attitudes among collegiate peers encourage more problem behaviors in actuality and that changing perceived norms can lead to changes in behavior. Moreover, social norms theory’s accounting for the predicted prevalence and persistence of misperceived alcohol and other drug norms has integrated early work by Sherif on norm formation and Asch on conformity. Social norm theory has also incorporated more recent social psychological work on false consensus and pluralistic ignorance.

Second, Wechsler and Nelson state there is little empirical support. I recently counted more than two-dozen academic journal articles consistently demonstrating pervasive misperceptions and another dozen articles and published monographs providing evidence of positive impact with social norms interventions. There are recent reviews of this literature (e.g., see H.W. Perkins. 2002. “Social Norms and the Prevention of Alcohol Misuse in Collegiate Contexts,” J. of Studies on Alcohol, Supplement 14, pp. 164-172; A.D. Berkowitz. 2003. “The Social Norms Approach: Theory, Research and Annotated Bibliography,” Higher Education Center for Alcohol and Other Drug Prevention, www.edc.org/hec/socialnorms/theory.html).

Lastly, Wechsler and Nelson attempt to discredit the social norms approach by claiming it is supported by the alcohol industry—positing “guilt by association.” This position ignores the fact that, regardless of one’s opinion about industry funding of some recent projects, all of the original case studies and published research introducing a social norms approach in student populations were funded solely by government grants and local school support. I highlight (H.W. Perkins (ed.). 2003. The Social Norms Approach to Preventing School and College Age Substance Abuse. San Francisco, CA: Jossey-Bass), a dozen case studies by the original experimenters who successfully implemented this strategy without any beverage industry support.

H. Wesley Perkins, Hobart and William Smith Colleges (perkins@hws.edu)