Professor Richard Cooke shares insights into a new research paper on University Students’ perceptions of the effectiveness of 11 alcohol control strategies

Professor Richard Cooke

Our recently published paper reports an international comparison of university students’ perceptions of the effectiveness of 11 alcohol control strategies, such as, increasing the cost of alcohol or teaching people skills to refuse alcohol. University students were recruited from Denmark, England, Germany, Italy, Portugal, and Switzerland because these countries reflect a range of different drinking cultures for students. For example, Danish and English students don’t drink that often, but when they do, they can drink a lot, like binge drinking in a pub, bar, or nightclub. In contrast, Italian and Portuguese students often drink every day but in small amounts, like a glass of wine with a meal.

The paper was based on previous research by Dr Richard de Visser from the University of Sussex, which showed UK adolescents and university students rated restrictive strategies, like increasing the cost of alcohol, as less effective than educational strategies, like teaching people skills to refuse alcohol. These results are interesting because they contradict high-quality epidemiological evidence that restrictive strategies are more effective at reducing alcohol-related harm than educational strategies. Our paper sought to extend these results to see if ratings of effectiveness were affected by drinking culture.

Our paper had three key findings:

1. We replicated Richard’s results from 2014 – university students rated restrictive strategies as less effective than educational strategies.

2. We found that ratings of effectiveness were affected by country of residence. For example, Italian and Portuguese students rated restrictive strategies as more effective than students in other countries. Alternatively, Danish students rated educational strategies as less effective than students from other countries.

3. We also found that different psychological factors predicted ratings of effectiveness for different strategy types. Students who reported less positive alcohol outcomes (beliefs about the effects of drinking) reported higher ratings for restrictive strategies, while students who reported higher drinking refusal self-efficacy (finding it easier to refuse the offer of an alcoholic drink) reported higher ratings for educational strategies.

There are three takeaway messages from this paper. First, we confirmed that university students’ view restrictive alcohol control strategies—like increasing the price of alcohol—as less effective than educational strategies at reducing alcohol-related harm. This result is completely in contrast to the epidemiological evidence, which favours restrictive strategies. Implementing unpopular, but effective, strategies that restrict students’ ability to drink alcohol, is going to be challenging. Second, we found country of residence affected ratings of strategy effectiveness. Southern European students gave more favourable ratings of restrictive strategies than students in other European countries, while Danish students gave the least favourable ratings of educational strategies. We need to conduct new research to explore these differences. Finally, we found that two psychological factors, alcohol expectancies and drinking refusal self-efficacy, predicted strategy ratings. It may be possible to target these factors in interventions to increase students’ ratings of the effectiveness of alcohol control strategies. This is one way to increase support for implementation of these strategies.

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