The increasing awareness of binge drinking as a problem, particularly amongst young people, has led to a string of policy announcements in recent months. It is a debate that is played out very publicly and has the government caught trying to assuage the drinks industry, the 'get tough' tabloids and health professionals, all at the same time.
All of this is based on an assumption that we know what binge drinking actually is. Binge drinking has been defined in a number of different ways; the majority of which refer to a certain number of units consumed in a particular session. I sometimes wonder though, whether this is not completely missing the point.
If we take young people as an example, much of the current focus is on education and awareness. The idea might be that if someone were aware of the facts, they could make a rational and informed decision about whether or not they should binge drink. A full understanding may result in someone reducing their consumption to recommended levels. However, this assumes that a 'binge drinker' is a rational consumer. A rational person would look at the prospect of a night out and think, 'I hope I have a good time tonight'. A 'binge drinker's outlook would be, 'I want to get completely smashed tonight'. It is this mind set that lies at the heart of binge drinking amongst young people.
I use inverted commas around 'binge drinker' because, of course every young person who binge drinks does not share this philosophy. This is why it is so important to segment our target audience in much more sophisticated ways than simply, 'young' and 'old' or 'rich' and poor'. A multi-pronged approach is required to tackle the problem. When I think of binge drinking though, I consider those whose purpose on a night out is to get as drunk as possible and subsequently, how to address that attitude. As a 23 year old, I remember (or in most cases cannot remember) frequently going out with exactly that intention. Even then, I knew the trade-off (good night blurred with memory loss versus hangover, hole in wallet, frequent regret) was not worth it. All the education and awareness in the world would not have made a blind bit of difference though. It was of no consequence whether I drank 15 units or 30 units; the important issue was my intention.
I do wonder whether it is helpful to attempt to define binge drinking at all. For those who wish to, I would argue that binge drinking has a lot more to do with why we drink than how much we drink.
There isn't a strong evidence base for the impact that public health campaigns - like the Know Your Limits campaign - have on the behaviour of their recipients.
Similarly drug education that focuses on developing young people's knowledge of the effects of drugs doesn't have a good record in changing behaviour (particularly where there are strong countervailing forces).
However, there are school based educational programmes which have proven to be effective in moderating the harms that heavy drinking can do.
You might want to take a look at the SHARHP programme (http://tiny.cc/TqIcj) which has been run in Western Australia, or the EUDAP programme that has been run across a number of European countries (http://tiny.cc/vYzFT). Both of these use a mixture of knowledge based education alongside sessions that are focused on changing attitudes and skills. They also share the use of normative information in developing young people's knowledge, skills and attitudes.
The EMCDDA has quite an interesting page on it's website about normative education (http://tiny.cc/C75Nq).
Posted by: Andrew Brown | 24 June 2008 at 11:11 AM