July 13, 2009 Blame it on peer pressure. When college students think that other undergrads drink a lot of alcohol, they drink more themselves. However, a new systematic review suggests that when college students learn they are mistaken about the actual normal drinking habits of their peers, they sometimes imbibe less often.
The reviewers evaluated 22 studies that involved 7,275 university and college students. All studies but one took place in the United States.
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.
In the European Union, where the review authors are based, alcohol is a serious problem. “In the UK, young people are drinking earlier and heavier than ever before,” said co-author David Foxcroft of Oxford Brookes University, in England. “Levels of alcohol consumption amongst 11- to 13 year-olds have almost doubled in the last 10 years or so.”
Not too surprisingly, the reviewers reported that university students have a tendency to drink excessively. They looked at how social norms — our beliefs about what is “normal” behavior in the people close to us — might influence students’ drinking. If a student believes that his or her peers drink heavily, it will likely influence the amount of alcohol the student personally drinks, the Cochrane reviewers say.
However, they say that much of peer influence is the result of incorrect perceptions.
Researchers in the 22 studies placed students into either intervention or control groups. Those in the intervention groups received personalized feedback about actual college students’ normal drinking habits, their own personal drinking profiles — quantity of alcohol consumed, calorie intake and money spent on alcohol — as well as the health risk factors involved in heavy drinking.
The interventions occurred in different ways: alone, either by mail or via the Web; or together with individual face-to-face or group counseling.
Interventions that occurred electronically reduced the students’ alcohol-related problems, drinking frequency, peak blood-alcohol content and drinking quantity.
For example, in three studies using Web feedback, 62 percent of the students reported a reduction in alcohol-related problems and a reduction of 1.2 points in the Rutgers Alcohol Problem Index, a 23-item questionnaire geared to adolescents, the reviewers found.
In addition, with Web feedback, 65 percent of the students reported that they were drinking less frequently. Most results were from three-month follow-ups.
Individual face-to-face feedback also led to students drinking less often, with two studies (217 participants) showing that 63 percent of students reported a reduction in their frequency of drinking.
Mailed and group feedback did not show any changes in drinking habits.
The reviewers say that Web feedback and individual face-to-face feedback were “probably effective” in reducing alcohol misuse.
“There were only a small number of good quality studies that we could draw on to make this somewhat tentative conclusion,” said Foxcroft. “More research is definitely needed, especially in different settings. We don’t know, for example, how well Web feedback would work in the UK, where the drinking context and culture is quite different.”
Jeanie Alter, program manager and lead evaluator of the Indiana Prevention Resource Center at Indiana University’s School of Health, Physical Education and Recreation, said that she, for one, thought the results for the group feedback would be more significant.
“I am a bit surprised by these findings simply because by providing normative information to a group, I would have expected that it would provide a level of social support for refusal,” said Alter. “A similarly minded group usually would back you up in your decision not to use.”
Reference: Moreira MT, Smith LA, Foxcroft D. Social norms interventions to reduce alcohol misuse in university or college students. Cochrane Database of Systematic Reviews 2009, Issue 3.
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