This review of literature on alcohol consumption in the UK was conducted to assist further studies on student's attitude towards drinking and the choices they make whilst at higher education. The focus of the literature review is to study and identify the motivations that encourage excessive alcohol consumption amongst university students, age 19 to 24.
This review will discuss previous studies and the existing knowledge base in this field by authors such as K.L Johnston, K. P Keeling and Engineer.Literature review
Mintel's (2004) estimates that there are 1,100 traditional high street pubs, 850 late-night bars catering for students and young people, 375 cafe / wine bars, 175 Irish pubs, and 200 other themes and late-night venues in the UK, there would now appear to be around "4,500 such outlets in the UK, with an overwhelming bias in their appeal to the 18-25 age group" (Mintel, 2004. See Skinner, H. et al 2005). Young people are drinking alcohol at a younger age and those who do, so are drinking in greater quantities than ever before (HM Government, 2007, p. 61).
Alcohol use is an accepted part of social interaction in the Biritish culture, and the majority of adults in England and Wales drink alcohol regularly (Home Office Research, 2002, p1) and this has created much interest for researching the field of alcohol consumption.
Although there is widespread agreement among researchers and policymakers that binge drinking is an important issue, there is no universally agreed definition of binge drinking or standard way of measuring its occurrence (Murgraff et al., 1999), however on simple terms in the UK drinking three pints of beer in one session for a man or drinking four bottles of Alco pop for women is binge drinking. Drinking to get drunk and typically drinking more than four units for a man or three units of alcohol for a woman, in one session is regarded as binge drinking.
A number of factors influence consumption of alcohol. Many researchers have proved that excessive consumption could be harmful (Carroll, 1991; Griffin and Weber, 2006). This form of social interaction which somehow has turned into a "norm" and a way of living to many people, can lead to high levels of alcohol consumption, resulting in long-term and acute health and social problems (Jonas et al., 2000). Norms are shared beliefs about what is the appropriate conduct for a group member and normative behaviour describes the uniformity of behaviours that characterises a group (Hogg, M.A et al, 2008, 291) and the influencing factors on this behaviour and the extent to which binge drinking it affects the society, has been and still is the centre of attention for many governments, academics, parents and youngsters.
Reducing binge-drinking is part of the government's health promotion strategies in Scotland (Scottish Executive, 2002) and England and Wales (The Strategy Office, 2004). Binge-drinking is associated with a range of health-related problems including violence (Swahn et al., 2004), drunk driving (Windle, 2003), accidental falls (Savola et al., 2005), and unsafe sex (Corbin and Fromme, 2002), and there is also the possibility of developing long-term health problems associated with alcohol consumption such as liver cirrhosis (Pincock, 2003, See Cooke, R.2006, P84), hypertension (Xin et al., 2001), and coronary heart disease (Marmot, 2001). Although current advice on sensible drinking, within the UK, encourages consideration of daily consumption levels and having alcohol-free days, the General Household Survey reported that, 36% of men and 13% of women within the 16-24-year age group exceeded these weekly consumption guidelines (Bridgwood et al., 2000, See Cooke, R.2006, P84). But do we as consumers count the unit of our intake? Do we see drinking three pints of beer as binging?
Going to college or university is a very exciting period for young people and at the same time it gives them the opportunity to face a number of challenges and make independent decisions. With the pressure of coping alone away from home with all the stress of course works, time management and the challenge of independent living without the support of family, many young people turn to their peer for help and support. This frequently results in a rewarding relationship and it is not uncommon for an individual to adopt the norms and the culture of the group in order to fit in and develop friendships.
The sense of independence, often for the first time in their lives, a wide range of demands on individual, interpersonal, academic and societal levels such as leaving home, developing autonomy, making new friends and peer pressure may put young drinkers at risk of substance misuse of alcohol (Larimer et al., 2005).
As Rehm et al. (1996) points out, drinking is a social act and In Britain socialising over a drink in the local pub in most neighbourhoods is common. It could be argued that this style of socialising is where excessive consumption of alcohol is most reinforced by friends buying in rounds which, naturally tends to encourage everyone in the group to drink faster and often to drink more than they would otherwise do. Therefore the social situations and behaviours that surround binge drinking play a crucial part in determining its outcomes (Engineer, et al. 2003).
Learning to drink come naturally as part of one's growing up in some cultures and especially in Britain and the process of getting to know alcohol gets influenced by family and peers which plays an important role in the shaping of a young person's behaviours and experience concerning alcohol, it therefore becomes necessary to investigate the social context within which people binge drink, in order to understand both drinking patterns and their consequences (Engineer, et al. 2003).
As the university is associated with making independent decisions, they could be considered as an excellent setting for students to learn about all the side effects of their choice of diet and lifestyle, whilst at higher education, especially as the health habits adopted during early years of independence can be hard to change later in life (Stewart-Brown et al., 2000, see Dunne, C & Somerset, M 2004). Therefore it is important for universities to educate their students about healthy living which has an impact on the quality of life after higher education. Universities are in prime position to promote and improve the health of their students by creating health-conducive working, learning and living environments, thus influencing crucial determinants of student health (Tsouros et al., 1998 see Dunne, C & Somerset, M 2004 ). Thus it could be suggested that universities can play a parental role for the students and by setting examples and creating awareness can teach young drinkers to drink responsibly and take consideration in their drinking behaviour. The role that university plays in drinking behaviour of students will be further investigated in later stages of this study.Social and peer group norm
People entering a new environment are more likely to get influenced by their peers. Attitudes towards intoxication are distinctly favourable amongst British youth compared with other countries in Europe and elsewhere (Martinic and Measham, 2008, see Measham, F 2007) however the positive outcomes of drinking sessions such as facilitating friendship formation and socialising for students cannot be discarded but this method of socialising carries some negatives and disadvantages which could get out of hand and have long term effects on the well being of young drinkers.
Students' drinking behaviour was found by Wechsler et al, to align more with that of their immediate social group than with that of the overall student population (2003); furthermore in a study by Johnston & White, the effects of group norms on binge drinking intentions were stronger for participants who strongly identified with the in-group (2003, p. 74). Wechsler and Kuo (2000) have also stated those perceptions of close friends' (or a close social group's) drinking norms are a stronger influence than norms of students in general (see O'connor L,D et al 2007) .
The rules that groups use as their values, beliefs, attitudes and behaviours become somehow a condition for being a part of the group and failure to stick to the rules can result in punishments and the most feared of which is exclusion from the group. Deutsch and Gerrard (1955) distinguished between injunctive, ought, norms, and descriptive norms, by claiming that individuals considered both what they perceived significant others thought they must do (subjective norm) as well as what they observed majority of others actually did (descriptive norm). Injunctive Norms are behaviours which are perceived as being approved of by other people whereas Descriptive Norms are perceptions of how other people are actually behaving and whether or not these are approved of (Straker, D 2008). As a result of role setting, although others in the social group may not want the individual to engage in a binge drinking session, they may binge drink themselves and this may be a more significant determinant of behaviour as the person would think if they are binge drinking then it is ok for me to also binge drink. It must be mentioned that this theory will be further researched in this study.Role models
Over the years research has shown strong evidence that relationship between parents and child has a vital role on one's development of personality and sense of self and in this case the child's drinking behaviour in adolescent years. Stacy and Davies state that:
"... the alienation or anomie often felt by young problem drinkers might well be related to the degree of guidance, interest and encouragement shown by parents in relation to a wide range of activities of which the supervision of drinking behaviour would be only one aspect". (Stacy and Davies, 1970:203). Family has always had a central role in a person's growing up, and the values and the environment within the family can form the basis of alcohol problems (through parental consumption or supportive attitude towards drinking and allowing underage drinking). The family can be the prime educator to a child and create awareness of dangers of excessive drinking and teaching sensible and responsible consumption of alcohol by setting good examples and models.
In support of Stacy and Davies's view on the effects of family relationships on one's drinking behaviour it should be said that the "attitudes and behaviours of parents regarding alcohol appears to be strong predictors of adolescent drinking" according to Jackson & Connor (1953).
An important effect of role models, when growing up may be the development of internalised expectations for alcohol effect. Now days it is very common for young adults to say "I am going out tonight to get drunk". But what aspect of getting drunk makes these heavy sessions of consumption so attractive to university student? Many studies have found a relationship between perceptions of levels of heavy drinking sessions and student behaviour. D'Amico et al. (2001) found that "lower levels of perceived student drinking appeared to be a protective factor for onset of binge drinking" among high school students (p. 347). Maney et al. (2002) found that "when respondents thought their friends consumed greater quantities of alcohol, the respondents' total quantity and frequency of alcohol use was significantly higher" (p. 229).
However in contrast with the view that families are the main source of issues when it comes to binge drinking whilst living away from home and independent as a student, it can be argued that parental drinking behaviour have less influence on a young person's drinking habits. The way students view alcohol and its effects also is highly influential on how much they drink and when they start drinking. As a child, while growing up it is common to watch parents, older siblings drink and the pleasure that they seem to get from drinking could form and develop expectancy of alcohol which will in later life influence the drinking patterns of young persons.
College students high in sensation seeking, immersed in the college culture, are likely to be seduced by the excitement and intensity of risk behaviours (Horvath&Zuckerman, 1993) which encourages positive attitudes towards intoxication between young people. The early teens appear to be a key age for young people's socialisation into normative drinking behaviour with a significant shift from a predominantly hostile view of drinking and drunkenness at primary school to a more favourable one during the course of secondary school (Fossey, 1994; Talbot and Crabbe, 2008).Cheap alcohol
It is very common that bars offer two drinks for the price of one, happy hours and trebles for the price of doubles. Cheap alcohol is fuelling an epidemic of binge drinking in Brittan and especially in University campuses and Hastings and Angus (2009, p28) also point out that "the unprecedented affordability of alcohol in the UK and anomalies in taxation are compounded by heavy discounting and price promotions, especially in the retail sector, and this encourages over consumption across the population, including by young people. The vast availability of cheap alcohol results in excessive consumption and a research by Robinson and Lader in 2009 found that In 2007, over a third (37%) of adults (aged 16 and over) in Great Britain had exceeded the recommended guidelines for regular drinking in the previous week. (Robinson & Lader 2009 accessed Hastings & Angus 2009).
Rising crime, death, social breakdown and violence are the result of availability of cheap alcohol. The new plan to increase the price of per alcohol unit to 50p to is a debatable solution offered by the health authorities. "The Chief Medical Officer, Sir Liam Donaldson, reckons a minimum unit price of 50p would reduce hospital admissions by 100,000 and save a quarter of the lives currently lost to alcohol-related causes" (See Channel4.com 2010), but the government ministers believe that there are other ways to cut down drinking in the UK such as educating people and providing an environment where responsible drinking is encouraged.
Supermarkets use price promotions on alcohol as a tool to attract customers, a recent report by Channel4 found that in most areas of Northern England (I.E Newcastle) the price of alcohol is as cheap as 12p per unit, meaning a large bottle of strong cider costs as little as 1.89 to purchase (See channel4.com 2010) making drinking much more convenient in the comfort of one's house.Conceptual frame work
In 2009 it was revealed that the culture of binge drinking was costing the UK 2.7billion a year (Anon, Alcohol awareness week report 2009. P4), due to "alcohol-related crime and disorder, injuries and illness, and lost productivity in the workplace" (Wall, A P 2007).
This review of the literature brings to attention some important factors which lead to excessive consumption of alcohol, peer pressure, availability of cheap alcoholic drinks and the level of awareness of daily recommended limit for alcohol consumption. However there is small evidence that the effectiveness of increasing the price of alcohol on reducing consumption on students has been thoroughly studied. This identified gap in the literature is used to form the basis of the following study.
After reviewing some of the existing key concepts in the literature, the following questions were chosen to be further investigated in this research project;
- Why do students drink?
- Do students view their drinking habits as binging and are they aware of how much the recommended daily limit is?
- Is there a link between the price of alcohol and levels of consumption by students?
This study was designed because "despite the acknowledged value of health promotion in educational settings and a concomitant plethora of research into health education in schools, there is a distinct lack of research focusing on University students, particularly in the UK (Stewart-Brown et al., 2000) and since University environment and lifestyle is associated with parties and alcohol consumption, it is important to pay more attention to this issue and work towards prevalence of binge drinking and teaching responsible drinking and creating awareness about not only extreme effects of alcohol such as drunk driving and fights but also health related issues.
To carry this research a mixed method of conducting data is adopted. In addition to focus groups, questionnaires will also be used to conduct data to provide a deeper insight of the objectives of the study and collect qualitative information to provide better opportunity to answer the research questions and make more reliable assumptions.
There are around 16,000 premature deaths each year in England and Wales associated with alcohol misuse, this number has doubled since the early nineties. Alcohol related hospital admissions are increasing at a rate of 70,000 per year in England costing the health service in England 2.7bn per annum (Anon, Alcohol awareness week report 2009. P4) which could be spent on people with non alcohol related health issues. These facts brings to attention the role that universities can play in educating students and working towards reducing the intake of harmful amounts of alcohol as "the University setting is considered to present an excellent opportunity to introduce health messages and encourage students to feel comfortable seeking health information (Keeling, 2001), and particularly as the transition to University is associated with making independent decisions (Stewart-Brown et al., 2000; Diebold et al., 2000; Keeling, 2001).
The benefits of this research are both professional and personal. The study is aiming to add to the knowledge base for an important development in understanding students' drinking behaviour and motives throughout their time in higher education. And also to help identify ways within which students could be encouraged to take more consideration in their drinking habits and create awareness of the consequences of the choices they make.
The first objective here is to study the motivations and rational behind alcohol consumption amongst students taking into consideration the social context of this behaviour and the influence of the immediate social group. The second objective is to look at students' general understanding of the guided recommended daily alcohol consumption while comparing and measuring their consumption habits against their knowledge of the guidelines. The final aim is to investigate the link (if any) between higher prices of alcohol and levels of consumption by students.Methodology
A mixed method of conducting data was selected for this study. In addition to focus groups, questionnaires were used to conduct data to provide a deeper insight of the objectives of the study and collect qualitative data to provide better opportunity to answer the research questions and make more reliable assumptions.
The questionnaire investigated the same topic as the focus groups but from a quantitative scale to provide a meaningful evidence of the topics discussed. Where appropriate in the analysis of the focus groups, the results from the questionnaire is referred to, to provide a deeper insight of the discussed topic in a qualitative format.
A random selection of students from Nottingham Trent University and The University of Leicester completed a self administered short survey.
Semi-structured focus groups were chosen as an appropriate method of gathering in-depth and qualitative data. This methodology has been successfully used in similar settings for binge drinking (Emery, Ritter-Randolph, Stozier, & McDermott, 1993, See Broadbear, J,T et al 2000) and also other health related behaviours like drug use (Warner, Weber, & Albanes, 1999). Furthermore as Rehm et al., (1996) argues, drinking alcohol is primarily a social act, making it necessary to investigate the social context of binge drinking in order to understand patterns and outcomes. Qualitative approaches are therefore appropriate because of their emphasis on "context-embedded behaviour" (Gilbert, 1990).
The analysis from the questionnaire provided the opportunity to triangulate the results conducted from the focus group and helped ensure that the results from both methods supported one another.
A total of 12 students participated in two focus groups. Each group consisted of 6 male and female participants who were at full time higher education and they were recruited at the university ranging from 19 to 24 years old. They were recruited by directly being asked to participate and also asking them to bring friends with them if interested. Participants from one of the focus groups were students from Nottingham Trent University and the other group were students from the University of Leicester. Both focus groups took place in study rooms at the library of Nottingham Trent University and the University of Leicester and they were both recorded.
The criteria for recruiting the focus group participants were that they were students and alcohol drinkers. The frequency of drinking was not in the agenda as it was decided students with different drinking patterns may engage in a discussion with one another and provide a breadth of perspectives.
The questionnaires were distributed online using the social networking site Face-Book and also a printed version of the same questionnaire was handed out in the SU bar at Nottingham Trent University and the University of Leicester to some of the students and they were asked to return the questionnaire before leaving the bar. 108 students participated in filling in the questionnaire.
Based on the research objectives and the literature review, the following topics were chosen to be further investigated and discussed.
- Why do students drink?
- Do students view their drinking habits as binging and are they aware of how much the recommended daily limit is?
- Is there a link between the price of alcohol and levels of consumption by students?
Two 30 minutes long focus groups were conducted during February 2010 and each consisted of 6 participants. At the beginning of each session with both focus groups, the study was fully described to the participants and they were assured of the confidentiality of their comments and offered the opportunity to have any of their comments erased from the tape if desired.
After this opening statement the discussion topics were introduced. The primary focus was to get all the participants to contribute and to continue the discussion on each topic until all the participants had given their opinion and no more responses were coming. During the discussion it was attempted and ensured to focus on the experiences of participants and avoid unrealistic assumptions.A note on interpretation
Quotes from individuals have been chosen to illustrate the range of viewpoints on each key theme in the research and each comment is identified by a person's gender and their year of education. Results from this study are categorised by the topics discussed and questions that were asked.
Data results and discussionQ1. Why do you think students drink? What is the motivation?
The discussion was started with a very broad question to get the participants talking with each other to ease the environment and help them relax in the presence of one another and the moderator.Overview of responses
Motives outlined by participating students included;
- Having fun
- Becoming a part of something, the sense of belonging, in this instance a social group who encouraged drinking
- Increased self confidence and meeting people, particularly for sexual reasons
- Letting go of the stress and pressure of course works and deadline and other stressful events
For most the participated students, the main motivation for drinking while at university were comparatively similar to those that influence non-students drinking, however peer influence becomes more important as freedom from parental control enables the individual to make decisions independently. "Drinking is a social act" (As Rehm et al 1996) and this group of students see nights out as a good way of bonding it emerged from the focus groups. Participants believed it was important to make friends and build relationships while at university.
A positive attitude towards feeling drunk and intoxication was a common merge in both of the focus groups. The participants described some positive effects of alcohol such as becoming more confidence and friendlier and open to socialise with strangers especially for sexual reasons. The results from the questionnaire go hand in hand with this theme that emerged from both of the focus groups.
The quantitative data show that meeting new people for sexual reasons is the second most important reason for students to drink as it increases their confidence (See appendix 2). This may be considered as a negative outcome of intoxication and it confirms Engineers' findings in his research in 2004 which identified intoxication as a risk factor to young peoples' health, he comments that "over-confidence can encourage young people to think they are invincible which can stop them from appreciating the risks attached to certain situation".
The results from the focus groups suggests that enjoyment is the main and most common reason for drinking among university students which is consistent with the findings of Webb et al, who also discovered in his research in 1996 that "the overwhelming majority of both male and female university students said that they drank alcohol for pleasure and to have fun". Risk taking and doing things that one usually would not do were described as a motivation for binge drinking.Q2. To what extent your friends influence your drinking behaviour?
The participants were asked to describe the answer by choosing from the following list;
- Very much so
- Only occasionally
- I drink when I feel like it
- My friends do not influence me at all
Although providing the multiple choices to describe the level of influence of others on their behaviour was rather structured but they were asked to also give some detail as how this pressure is enforced and some interesting themes emerged. Some hesitation accord during the discussion of this topic, particularly amongst the older participants, this could be due to personal issues as individuals see themselves as free human beings who choose freely.
Some participants from group B commented that their friends did not always directly encourage them to drink and that they drink out of choice. In spite of this comment, it could be argued that although they claim to have complete control over their alcohol consumption, their choice to drink could be under the influence of the environment and their immediate social group. A study by Johnston & White in 2003 discovered, the effects of group norms on binge drinking intentions were stronger for participants who strongly identified with the in-group (2003, p. 74). So referring back to the results from the previous topic that found students take part in drinking session to bond with one another and build relationships, it could be suggested that the fear of being left out of the social group especially when living away from home and relying on new relationships, encourages students to take part in regular drinking sessions particularly if that is what their immediate social group values.
"Well it's just that when all your housemates go out and your left alone at home, you feel kind of left out and can't help but wonder what they are doing and wishing that you had gone out too, you can't deny that alcohol helps you have a good time"
(Second year male student)
However, some participants from group A admitted that they are influenced by their friends and the temptation is hard to resist when they have no other plans. Students from the focus group commented that very often the only time they turn the offer for drinking down is near deadline for assignments and exams. This theme was also highlighted by some of the older participants from focus group B. They reported during the first year at higher education they were more open to offers from others for going out for drinks, than they are now being in level two or three.
They discussed during the first year at university as a fresher students have a very different perception of university life style and all the activities associated with it but as time goes by the routine becomes repetitive hence it loses its attractiveness. So it could be argued that students mature out of this routine in later stages of their time at university and cut down on their drinking behaviour as they take up more important roles in final years of their higher education. However in spite of this result as the literature review suggests "the health habits adopted during early years of independence can be hard to change later in life" (Stewart-Brown et al., 2000), for this reason it is important for students new to the university lifestyle to adopt a health balance of alcohol consumption and diet.
Not surprisingly the results from the questionnaires show that the majority (78 percent) of first year students felt pressured by their social group to take part in drinking sessions (See appendix 3). This demonstrates, as it has been discovered before by many authors (Johnston & White 2003, Webb et al 1996), the immediate social group is highly influential on an individual's drinking habits, especially for new students who feel the need to make friendships and use this method of socialising as a facility for making friends and fit in with those around them. The data from the questionnaire were analysed on the basis of the year of education at university.
Furthermore it could be said that alcohol consumption is seen as a shared activity and a must to do, in many social groups and the excitement and unexpected events that accurse makes this more appealable to students who may have less responsibilities compare to non-students in the same age range. Furthermore both focus groups commented that they do not feel being offered a drink by their friends is at any form a pressure and they appeared happy to be persuaded to drink alcohol.
"I wouldn't call it being pressured... we're not 12 anymore and if you don't want to do something, you don't want to and it's easy to say no..." (First year male student).Q3. Do you know what the recommended daily limit of alcohol consumption limit for man and woman is?
The participants had a mixed understating of this topic. Only three students from focus group B knew what the recommended limit exactly is. Others participants complained that the measurements are complicating and unclear. In addition to the focus group a series of questionnaires were also used to answer this question and get a better overview of students' awareness of recommended limits and allowances of consumption.
Results from the questionnaire suggested that 66 percent (See appendix 4) of the respondents are not well informed about the permitted/recommended blood alcohol limit. This could be explained by possible difficulties in understanding the exact measurements, a lack of availability of such information in schools or colleges where students were more likely to get introduced to their first drinks in early years of life or at the university or perhaps recent changes in regulation has caused some confusion. From the discussion of this topic it is apparent that to this group of students drinking is such normal everyday behaviour that they do not think twice about how much they drink in one session and even if do not drink heavily to get drunk it is still likely for them to go over the recommended limits as some of the participants reported they could have up to three or four drinks during a social.
Another reason for this confusion may be the introduction of new types of alcoholic beverages with increased alcohol contents, some drinks sold are more contains variable quantities of alcohol units which is difficult to understand according to the findings of the focus groups.
This topic needs more in-depth exploration as many young students seem to ignore the guidelines and take part in binging sessions, putting their safety and health at risk of serious problems such as liver diseases, cancer and also physical injuries. Although a few participants from the focus group were aware of these guidelines, they commented some weeks they avoid drinking during the week and save the units for the weekend which is a wrong perception as the liver should not be swamped by 15 to 20 or even more units of alcohol at once because "the liver cells can metabolise only a certain amount of alcohol per hour. So if alcohol is drank faster than the liver can deal with it, the level of alcohol in the bloodstream rises making the liver to work faster (Alnga, M. 2001)Q4. What is your drinking pattern like? Do you exceed the limit and why?
To avoid ambiguity about the meaning of excessive drinking students were informed of the guided recommended daily limits of alcohol units prior to the start of this discussion.Overview of responses
To get a general understanding of the overall drinking patterns among 19 to 24 years old university students and to understand the role that 'binge' drinking plays within their lives a series of questionnaires were distributed and received 108 responds which supports the findings of the focus groups.
The result from the questionnaire revealed that 67 percent of students exceeded the recommended guidelines for alcohol intake more than twice a week (See appendix 5). It must be stated that most of which are in their first year of education (See appendix 6).
Throughout the discussion of this topic in the focus groups when the participants were asked to somehow explain why themselves or other youth binge drink they could not give a rational explanation. Their statements and comments on this issue were typical simple answers such as;
"There is no need to think about why you're drinking too much. You want to have a good time and alcohol and I mean lots of it makes your night more interesting. Everybody does it, its normal". (First year student, male)
"You've got to do it while you're young, it's a social thing, it boosts your confidence, helps you meet people, especially guys..." (First year female student)
Based on given reasons by student who admitted to have heavy sessions of alcohol consumption on a weekly basis, the key explanation for this behaviour may be that it is a central part of social scene for students, which they enjoy and do not consider it harmful or a problem. According to Mintle (2004) there are now around 4500 pubs, bars, restaurants which cater for students, "with an overwhelming bias in their appeal to the 18-25 age group" ( Skinner, H et al 2005). "UK alcohol industry spends approximately 800m each year encouraging consumption of its wares. Alcohol marketing communications have a powerful effect on young people and are independently linked with the onset, amount and continuance of their drinking" (Hasting, G and Angus, K 2009, p1). With the major market players and their huge investments on advertising and the powerful use of marketing communication mix, such as price promotion, vast availability of alcohol and new inventions such as Alco pops which are promoted as ready to go drinks, no wonder why young people and especially students binge drink in despite of all the evidence that has proven "excessive consumption could be harmful (Carroll, 1991; Griffin and Weber, 2006).
It is important to mention the results from the questionnaires suggested that although 67 percent of students reported that they exceed the recommended limit of alcohol intake more than twice in most weeks, only 43 percent of them admitted to binge drink and the majority of others view their drinking patterns as normal (See appendix7). This could be due to lack of knowledge of the recommended level of alcohol consumption which was highlighted in the previous discussion of alcohol consumption guidelines.
Focus group A and B both recognised the university environment as an encourager for drinking. They commented that going to university is the start of a whole new chapter in their lives. No parental supervision, the wide spread of alcohol availability, the need to make new friends and to build new relationships all contribute to ignoring all the risks and disorders of heavy episodes of drinking, identifying university as an influential factor of binge drinking.
It must be addressed that not all the participants in the focus groups clearly admitted to regularly binge drink and they tended to give examples of their friends and not directly their own experiences when directly asked questions or commented on the topics.
Another consistent theme that emerged from both focus groups was that the risks and disorders that could happen on a session of heavy drinking are often seen as part of the excitement of getting drunk on a night out with friends. They admitted that often they go out with the intention of getting drunk which is supported by the result from the focus groups. Intoxication and increased confidence were rated to be the main reasons for alcohol intake by students in the survey, it was discovered that increased confidence in self encouraged students to do things that they usually would not and take risky behaviours and this finding confirms Horvath & Zuckermans' (1993) view that suggests "College students high in sensation seeking, immersed in the college culture, are likely to be seduced by the excitement and intensity of risk behaviours which encourages positive attitudes towards intoxication between young people.
"It's a part of our culture to go out to get drunk, we've been brought up with it, you hear how fun being drunk is from your siblings, you see it on television from very early age" . (Third year female student).
The findings of the discussion of this topic has once again proven that although there are many campaigns promoting sensible drinking, they have not yet been successful in getting the message across to young university students and as drinking is linked to personal choice, student tend to ignore the harmful side effects of alcohol and trade health for pleasure. It is apparent that most people are worried about extreme side effects of binge drinking such as fights, sexual harassment or drunk driving and tend to ignore the health related harms that alcohol consumption could cause and little attention is paid to this part of the story.Q5. Do you blame the vast availability of cheap alcohol for excessive consumption by university students? Overview of responses
67 percent of the students believe that higher prices for alcohol would encourage them to buy and drink drinking alcohol. (See appendix 8)
According to the National Statistics and Economic Trends "rising disposable income for households and relatively stable alcohol prices has led to a situation where alcohol is now 65 percent more affordable than it was twenty years ago". (ONS publication Focus on Consumer Price Indices, See Alcohol concern 2007).
The aim of this question was to investigate the extent to which drinking behaviours are affected by the availability and affordability of alcohol to students.
It was gathered from the focus groups that there certainly is a link between students' income and their alcohol consumption. The vast availability of cheap alcohol encourages students to purchase more than their recommended daily alcohol consumption limit especially on student nights out and "when we are short on money, we go to even cheaper bars who sell 99p a drink" (First year female student). Some participants commented that they use strategies such as having a few drinks at home before going out, drinking shots of pure alcohol and mixing their drinks to help them intoxicate much quicker on a night out
Bars and night clubs who open till early hours were blamed by participants in group A, for excessive drinking, "if it closed earlier we will go home sooner and drink less" said one of the participants. In contrast group B thought that bars and clubs shouldn't shut too early as when it does, they have to drink more quickly to get drunk and at the time they don't realise how drunk their getting and how much they are consuming.
However, it seems unlikely that the factor of closing times is particularly significant as there are many alternatives to bars and clubs for students. According to Expenditure and Food Survey, Overall household expenditure on alcoholic drinks increased by 86% between 1992 and 2007 (See The NHS Information Centre, Lifestyles Statistics 2009) this could also relate to students. They can choose to drink at home with friends as it is cheaper to do so when they live in a budget, it emerged from the focus groups.
Furthermore the result from the questionnaire also supports the findings from the focus groups. Respondents to the questionnaire were asked to identify two encouraging factors for the heavy drinking culture in university, and they identified availability and affordability of alcohol with 39 percent, to be the most important encouraging element and the university environment came second with 26 percent of the responds (See appendix 9)
To conclude, the results from the discussion of this topic suggest that the reasons and motivation for excessive drinking by students is fairly similar to non-students' motives, however pricing may play a more important role for students as many may live on restricted budget and the result suggests marketing campaigns that are price orientated are successful with regards to attracting students. It may be argued that increasing the price of alcohol to lower consumers' purchase ability may be an effective way of tackling this issue. Much research in this field "has found that taxation and price changes have larger effects on young people compared to the overall population (sterberg 1995; Godfrey 1997; Chaloupka 2004. See Hastings,G and Angus, K 2009. p28) and as discussed previously since the reasons and motivation for students excessive drinking is fairly similar to non-students, increasing prices may be more effective to help reduce excessive consumption by students due to limited income for most.Q6. Who is responsible for protection from the harmful effects of alcohol consumption?
Overview of responses
Majority of students who were in their later stages of education and those who had done the late night heavy drinking sessions in their first and second year believed that the individuals must take full responsibility for protecting themselves from alcohol-related harm. This theme emerged from both of the focus groups. In addition to this result the findings of the questionnaire also suggested that more than half of those students, who regularly took part in heavy drinking sessions, tend to more emphasis on the responsibility of individuals in protecting themselves from alcohol related harm (See appendix 10) and the more drink they consume in one session the more they believe personal responsibility for their action.
"You go to the SU bar for lunch and get tempted to have a pint of beer instead of coke, they are the same price and calories are more or less the same too, so you think why not?" (Second year Male student)
On the other hand younger students, who were in their early years of higher education believed that the university must take responsibility to protect students from harmful consequences of alcohol consumption. They commented that as long as the university and student accommodations are surrounded by pubs and bars who offer drinks for as little as 99p the authorities at university should take full responsibility. This view could be supported by the results from the questionnaire that found quite a significant proportion of students 23 percent, think that public authorities and university have to intervene in order to protect students.Effects of parental drinking behaviour on students
This study aims to identify if any links exist between parental drinking behaviour and the child's drinking habits. However as this may be a sensitive subject to some students this topic was not discussed in neither focus groups and it was decided to rely on the results from the questionnaire only which limited the quality of the data and the effects of parental behaviour on adolescence drinking needs a more in-depth approach which could examine all the dimensions of this topic.
Although the questionnaires were self administered which may make the result bias to some extent, the findings are not consistent with the theory that "attitudes and behaviours of parents regarding alcohol appears to be strong predictors of adolescent drinking" according to Jackson & Connor (1953) which was mentioned in the literature review. Nearly half of the participants (48 percent see appendix 12) reported their parents to be either social or non-drinkers but 68 percent (Appendix 5) of the students themselves admitted to regularly take part in binge drinking sessions and when they were asked if their parents influence their alcohol consumption habits, more than half of which (58 percent, see appendix 11) claimed that their parents' non-drinking or social drinking behaviour has not encouraged them to drink less or influenced their choice to drink at any form while at university.
Although the results of this questionnaire cannot be generalised due to the small sample size, when compare the data it is apparent that parental drinking habits plays a small role on the students' choice to binge drink and the influence of peers is much greater on this matter and this finding is supported by Maney et al. (2002) found that "when respondents thought their friends consumed greater quantities of alcohol, the respondents' total quantity and frequency of alcohol use was significantly higher" (p. 229). As mentioned, participants felt that families and parents' drinking behaviour do not effect and or encourage young people and in this instance students' drinking pattern, the possible potential of the family to prevent heavy drinking is an area which may be useful to explore further and parents and siblings could be the primary educators of children.Chapter 3
The aim of this study was to assess the attitudes and beliefs of University students regarding binge drinking with both qualitative and quantitative approach. The data collection methods featured students' focus groups and questionnaires. Of course the data from this study cannot be generalised, however some interesting results should be considered from this study. Firstly, participants reported binge drinking as a normal part of the university experience and they believed that after their first and second year of education they will eventually cut down on drinking. Secondly, it was reported that although the majority of participants did not have a clear understanding of recommended daily guidelines of alcohol intake, the guidelines have little power to control binging amongst students and they did not see their drinking behaviour excessive which could be explained by two reasons, they are either in denial and do not perceive this behaviour as an issue or are generally unaware of how much alcohol is too much. Finally the availability and affordability of alcohol directly affects the consumption behaviour according to the participated students.
The findings of this paper adds to the existing literature on the motivations of drinking by experts in this field such as Rehm et al(1996) and Engineer et at (2003) about the motivations and encouraging factors for drinking.
In sum, during the early months at university many students initially increase their alcohol use and then decrease it in later stages at life at university i.e. final year. This group of students see drinking as an activity and associate it with the university life style that many people take part in when entering higher education, making it culturally normative for most. Some gap in the literature on alcohol and its price related issues was identified which this study aimed to further investigate to provide a deeper insight of the pricing of alcohol and investigate its link to binge drinking by young drinkers at university.
The results suggests that binge drinking is greatly influenced by living away from home and the influence of peers is highly effective on choices that students make whilst at university and in particular in their first year of studies when they are learning to live independently and take responsibility for own actions. Some students go out with the intention of getting drunk and they even do things to enhance the speed of their intoxication. Although the findings of this study are limited due to lack of resources, a price increase strategy appears to be most effective solution for tackling binge drinking by students; it was gathered from the study. Also this study suggests that the intentions for binge drinking encourage this behaviour, therefore it could be suggested that if these intentions and positive expectancies of alcohol do change and alternative facilities for socialising is introduced in an alcohol free environment, students would cut on their levels of alcohol intake.
As highlighted many students drink at home before going out to spend less money, as a result they go out much later in the evening and by the time they get to a bar or club they are drunk which puts them in higher risks and disorderly. It could be argued that the suggested minimum pricing strategy as reviewed in the literature could make a positive contribution to tackling this phenomenon, which would reduce alcohol consumption for good.
"Damages done by alcohol costs the society 2.7 billion each year" (See Channel4.com 2010) so it may be suggested that increased prices of alcohol would help lessening alcohol related crime, alcohol related illnesses and hospital admissions helping the governments to cut costs on public services such as police and the NHS. Creating awareness alone about the harms and disorderly behaviour caused by alcohol may not be most effective. Counteracting factors that encourage this behaviour and appropriate restriction on availability and affordability of alcohol and also tackling the positive attitude and expectancies of alcohol all may assist the reduction of alcohol consumption by young drinkers at university.Reflection and recommendations
This study was based on a rather small sample of students from two universities therefore the findings cannot be generalised or applied to all students from other universities where the university environment may offer different facilities to students.
Additionally studying the effects of the social aspects of drinking alcohol is influenced by some methodological weaknesses in this study. Due to limited resources a convenient sampling method was adopted which failed to consider demographic differences when carrying out the study. In addition issues such as small sample size and low response rates affected the reliability of the findings of the study and the basic knowledge of the moderator limited the quality of the data.
However the approached methods had certain advantages. Although the discussion was within an artificial setting, the atmosphere was comfortable and informal and at the same time informative, as a peer moderator who was familiar with the university lifestyle interviewed the focus groups. The qualitative data of this study were supported by quantitative data and this approach helped give detailed information about the social context and the motivations that encourage binge drinking. Also the combination of students with different age groups in the focus group introduced variable viewpoints about different topics and helped gain a deeper insight to the topics.
As mentioned before the aim of this study is to provide a knowledge base for further studies about alcohol consumption by students. For future studies it would be useful to recruit non drinkers and ethnic students who avoid drinking for personal reasons may help identify ways for preventing heavy alcohol consumption.
Furthermore to prevent binge drinking investigating and exploring the existing theories and programs aimed at reducing alcohol consumption is beneficial. Experts and people who are directly in contact with young people such as parents and university staff and young drinkers and non-drinker maybe consulted to use their experience and knowledge on alcohol related education programs in developing a solution to deal with this behaviour, however it seems unlikely that the positive attitude towards alcohol consumption would change without difficulty and it requires long term strategic planning.
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