Wasted potential: The role of higher education institutions in supporting safe,sensible and social drinking among students

Abstract

Setting:

The United Kingdom (UK) government has acknowledged that there is a problem with excess alcohol consumption, in particular amongst young people. Higher education is an important health promotion setting in which to explore not only how sensible drinking patterns can be facilitated and embedded in students’ current lifestyles but also how students, as future citizens, can inform policies which, in turn, will impact on future populations.

Objective:

This study aimed to explore and disseminate current practice relating to the promotion of sensible drinking amongst students attending higher education institutions (HEIs) in the south west of England. Along with the identification of examples of current practice, the study aimed to identify current issues and concerns relating to alcohol consumption amongst students.

Method:

Survey data from HEIs across the south west of England were gathered using questionnaires to key respondents in each institution. To further investigate what information on sensible drinking is available for students, an electronic search was made of each of the HEI’s websites for relevant materials, initiatives and policies.

Results:

The HEIs involved in this study used a wide range of approaches and initiatives related to sensible drinking amongst their students. All of these contribute towards encouraging a culture of safer and more sensible drinking-related behaviour amongst students, and towards an emerging body of good practice.

Conclusion:

With the backdrop of the government’s alcohol strategy, and the evidence linking excessive alcohol consumption to less productive student learning, recommendations are made to enhance this work in a more coordinated and sustainable way.

Keywords

Alcohol health promotion higher education students sensible drinking

Introduction

Higher education is a highly influential sector both in terms of its constituency of staff, students and wider communities and also its global reach. It hence has the potential to impact positively on public health. In the United Kingdom (UK) there are 169 higher education institutions (HEIs) with almost 2.4 million students and more than 370,000 staff.^1,2 Currently there are 13 HEIs in the south west region with an estimated student population of around 140,700 (2008 statistics). These 13 HEIs employ 20,000 staff with an estimated 44,000 additional posts being supported. The aim of this study was to explore and disseminate current practice relating to the promotion of sensible drinking amongst students across 12 of the 13 higher education institutions in the south west of England (the Open University was excluded due to its virtual environment).

Current sensible drinking guidelines suggest weekly alcohol consumption should not exceed more than 21 units for men and 14 units for women. Since 1988 there has been a reported increase in drinking above these guidelines.³ Average alcohol consumption amongst young men aged 16–24 years has fallen in recent years; however, amongst women in the same age group average consumption has increased.³ Binge drinking accounts for around half of the alcohol consumed in the UK. Binge drinking is defined, according to the Cabinet Office,⁴ as drinking more than twice the daily guidelines; this equates to drinking eight units or more for men and six units or more for women. However, the definition of binge drinking is controversial, with the Department of Health and Home Office defining it as ‘drinking too much alcohol over a short period of time e.g. over the course of an evening’.^{5,p. 4} The UK government has acknowledged that there is a UK problem with excess alcohol consumption, in particular amongst young people.⁶ In 2010 the coalition government published a report pledging to:

ban the sale of alcohol below cost price

review alcohol taxation and pricing to ensure it tackles binge drinking without unfairly penalizing responsible drinkers, pubs and important local industries. Over the past few years there has been growing concern regarding the increase in alcohol consumption and its effect on health.⁷ Young people including students in higher education have adopted alcohol consumption as a pastime. This has over time raised national concern regarding the numbers of young people drinking to excess.

Excessive alcohol consumption has increased over the past 17–25 years, particularly amongst women,^3,7 and in relation to binge drinking. The links between sexual assault and violence and excessive alcohol intake amongst university students has been well documented.^8,9 According to a study by the United States of America Department of Justice, 20–25% of female college students will be raped during their college years, with many of these cases being alcohol related.¹⁰ Women are both more susceptible to the effects of alcohol and are more likely to be victims of sexual assault or violence.⁸

Excessive alcohol consumption is known to have a detrimental effect on students’ health and wellbeing.^8,9,11 Alcohol consumption amongst students in higher education has been highlighted as contributing towards poor study skills and an inferior learning experience.¹¹ Moreover, excessive alcohol intake has been linked to violent behaviour amongst university students.^8,9

Alcohol has become more affordable over the past 50 years.¹² This is likely to have contributed, at least in part, to the increase in alcohol consumption amongst young people. According to the Alcohol Strategy for England and Wales, the coalition government plan to introduce a minimum price for alcohol of around 45p per unit. This is most likely to affect heavy drinkers,¹³ but will also reduce the availability of cheap alcohol which is often purchased due to its affordability by young people. These recommendations were further supported by Coghill et al.⁷ when presented to the Houses of Parliament in 2009 as part of a report on changes in alcohol, consumption and alcohol-related harm over the past 25 years. However, the issue of minimal pricing on alcohol consumption remains controversial and requires close stewardship.¹⁴

Alcohol education and health-promotion campaigns more generally have been shown, with some rare exceptions, to have little or no positive effects on drinking habits or alcohol-related problems.¹⁵ However, the aim of mass communication in health promotion is to raise public awareness and create a climate of opinion conducive to policy change as well as, and in order to, shift attitudes and prompt behaviour change.¹⁶ Campaigns need to be appropriately targeted and promoted in order to gain maximum effect. Previous health-promotion campaigns focused on drug-related behaviour, such as tobacco smoking, have been shown to be effective.¹⁶

The promotion of sensible drinking using a multi-faceted approach, as has been effected with tobacco consumption, is key to reducing the harm associated with excessive alcohol consumption. The aim and objectives of this study are informed by the government’s public health strategy,^17–19 the World Health Organization’s strategic framework for health promoting universities,²⁰ the UK Public Health Association’s publication ‘Climates and Change’,²¹ the English Healthy University Strategy ^22–24 and the UK’s most recent alcohol strategy ‘Safe. Sensible. Social’.⁵

Methods

Ethical approval for this study was granted by the University of the West of England (UWE) ethics committee in July 2009. The purpose of the investigation was to identify what information regarding sensible drinking was available for students at each HEI, and to explore any current issues and concerns relating to student drinking. Key individuals and university websites within each included institution were identified as sources of knowledge in providing sensible drinking advice.

An explanatory letter was emailed to each potential key individual identified within each HEI along with a consent form and a questionnaire. Respondents were requested to complete and return the questionnaire within three weeks. This enquired about activities relating to the promotion of sensible drinking, and issues of concern within their own institution. A reminder was emailed to non-responders after three weeks with further follow-up by telephone. To further investigate what information on sensible drinking is available for students, an electronic search was made of each of the HEI’s websites for relevant materials, initiatives and policies.

Results

There was a 100% response rate (n = 12), although not all university representatives answered all questions. Details of the universities included are described in Table 1.

Table 1.

Higher education institutions in the south west of England.

Institution
Arts Institute Bournemouth
Bath Spa University
Bournemouth University
Open University in the South West (not included in the study due to virtual environment)
Royal Agricultural College, Cirencester
University College Falmouth (incorporating Dartington College of Arts)
University College Plymouth St Mark & St John (MARJON)
University of Bath
University of Bristol
University of Exeter
University of Gloucestershire
University of Plymouth
University of the West of England, Bristol (UWE)

Responses to the questions asked were as follows:

Anticipated support required to help promote or facilitate sensible drinking amongst students and currently available resources

Of the six HEIs who responded to this question, four identified the following types of support required:

information on the number of units in different alcoholic drinks

Videos/DVDs on drink driving

literature including leaflets and posters focused on sensible drinking distributed through the students support services and in collaboration with the students’ unions (SUs)

the development by students of web links to information on alcohol and sensible drinking sited within the institutions’ own web pages that are specifically focused on the individual HEI student populations.

Web searches using the search term ‘alcohol’ on the main search facility of individual HEIs, the SU pages and the student wellbeing pages revealed that nine out of the 12 HEIs had accessible information relating to alcohol. These on-line resources included:

links to external organizations and public health campaigns providing advice on alcohol consumption and sensible drinking

internal counselling facilities

fact sheets providing information on the effect of alcohol

references to student handbooks and policies relating to alcohol consumption

events involving advice on alcohol and related issues

the promotion of alcohol-free events.

Alcohol and related policies

Six HEIs including student unions reported having a policy specifically related to alcohol. A further three had documented procedures for dealing with excess consumption of alcohol amongst their students.

Student union alcohol initiatives and promotions

Several HEIs reported that their students’ union discouraged alcohol promotion type activities such as drinking games, ‘happy hour’ and activities organized by the commercial organization ‘Carnage’. Some HEIs stated that promotions of this type would contravene their students’ union policy on corporate social responsibility. However, a few HEIs indicated that their students’ union bar did have an end of term promotion, with some calling it ‘drink the bar dry’ and others using titles less indicative of excessive drinking.

Advice and support for students who do not want to consume alcohol

Out of the eight HEIs who responded to this question, three identified that they were considering offering non-alcohol focused social events. Some HEIs and students’ unions offered fresher’s week activities that were not alcohol focused or ran a special week of events that were not alcohol focused. All eight HEIs identified that their student welfare, counselling or chaplaincy services were available to help support students who needed advice, in addition to the student help lines.

Reported incidents

Eight out of the 10 HEIs who responded identified that excessive alcohol consumption amongst students had caused problems that had resulted in the incident being reported internally or to external authorities. The most common problems identified included: binge drinking, anti-social behaviour on campus late at night, fire alarms being activated due to raucous behaviour, noise, verbal abuse towards other students and staff, drink driving, passing out and being admitted to hospital, and violence towards others and being victims of violence

Lead departments and collaborators

Lead departments, organizations and collaborators involved in healthy university related initiatives together with details of the initiatives are detailed in Table 2. Most activities were initiated through the students’ union; however, collaboration with outside agencies, especially the local police, was common.

Table 2.

Details of the initiatives aimed at promoting sensible drinking identified across the participating institutions.

Promotional material relating to sensible drinking and alcohol-free areas mailed out to all freshers from the students’ union

In-house campaigns using fact sheets, student volunteers and quizzes to promote sensible drinking and resist peer pressure fact sheets

Commercial campaigns (funded by Diageo)

Alcohol-free events and soft drinks promotions

Best Bar None awards

Working with local police and retailers to reduce alcohol-related anti-social behaviour

Working with HEI security to ensure night-time safety after drinking events

Protocols to report alcohol-related anti-social behaviour

Training sport and social committee members in sensible drinking strategies to discourage irresponsible drinking

Training on-campus bar staff regarding responsible retailing of alcohol, management techniques and how to deal with intoxicated customers

Students’ union paid officers present at initiation ceremonies

Student volunteers

Manifesto pledges through the students’ union

Discussion

This paper has explored current practice relating to the promotion of sensible drinking and issues of concern across the 12 HEIs in the south west region and to identify practice that could be shared across the region.

Responses show that there are a number of targeted interventions in place to facilitate sensible drinking amongst students. Alcohol consumption, particularly among young people, is one of the government’s public health priorities.¹⁸ The Chief Medical Officer’s recent report¹⁹ highlights as a priority the health and wellbeing of young people, in particular with regard to health-related behaviours. There is an ongoing governmental debate regarding the proposal for a minimum pricing policy of around 45p per unit of alcohol.²⁵ This proposal has been supported by a recent report published by Alcohol Concern and presented in parliament,⁷ which highlighted how the increase in alcohol was related to mortality and morbidity trends during the previous 25 years.

This project highlighted evidence of collaborative initiatives involving partnership working both within HEIs and with external organizations. Further partnership and community involvement is needed which also supports one of the key aims of the national healthy university initiative to create healthy and sustainable working, learning and living environments for students, staff and the wider community. Collaborative working ‘to shape an environment that actively promotes sensible drinking’^{5,p. 6} has been identified as one of the core strategies in developing an effective national alcohol strategy.

The activity and involvement of commercial partners such as Diageo can be seen as positive in that it provides access to finances and promotional materials. Additionally, it facilitates the commercial partner to engage in corporate social responsibility initiatives, as well as providing an external avenue of partnership for student unions. However, it could present a conflict of interest and an ethical dilemma for the HEI. Commercial organizations rarely become involved in projects for purely altruistic reasons. Therefore the branding of any campaign or promotional materials may need to be carefully considered to ensure that it does not serve to act as a surreptitious form of advertising for the companies or drink brands themselves.

This study found that alcohol and related policies were often ‘hidden’ or incorporated into other policies regarding disciplinary procedures. We acknowledge that, in some instances where HEIs did not report having a specific alcohol policy, this may have been due to a lack of awareness of the existence of the policy rather than its absence. Where an HEI has a written policy regarding alcohol and associated codes of conduct, it is important to ensure that this is widely known and available to both students and all staff.

The provision of alcohol-free areas in which students can socialize is important for students from cultures where the consumption of alcohol is not acceptable. It is important to consider how to raise awareness of ‘alcohol-free’ spaces across the higher education sector. The examples of good practice referred to in this paper may be used as a catalyst for regional and national debate.

The English Network of Healthy Universities (www.healthyuniversities.ac.uk) has agreed that a healthy university approach^21–23 should entail a commitment to:

creating healthy and sustainable working, learning and living environments for students, staff and visitors

increasing the profile of health and sustainable development in teaching, research and knowledge exchange

contributing to the health, wellbeing and sustainability of the wider community and evaluating their work, building evidence of effectiveness and sharing learning.

In 2004 the UK government responded to a groundswell of interest and activity relating to both healthy colleges and healthy universities by including reference to further education and higher education sectors in its 2004 White Paper ‘Choosing Health’. Higher education represents a large-scale sector that has a unique combination of roles. These roles can be harnessed to focus and mobilize their education, knowledge exchange, research, corporate responsibility and future shaping agendas to achieve significant impacts in improving health and wellbeing.²² University policies and practices can impact on students’ private lifestyles, work time activities and wider family networks. Therefore higher education employees and students are in a position to absorb and impart information, both as educators and citizens of the future.

This exploratory study identified that, while some initiatives were being evaluated, this was ad hoc and often conducted internally. Independent evaluation of both the process and impact of any initiatives is important, but may be costly. However, even in the absence of robust evaluation to assess the full impact of initiatives, there are many examples of good practice which can be disseminated and shared.

The way forward

This study has identified a number of examples of good practice. The HEIs involved in this project used a wide range of approaches and initiatives related to sensible drinking amongst their students. All of these contribute towards encouraging a culture of safer and more sensible drinking-related behaviour amongst students in HEIs and towards an emerging body of good practice. With the backdrop of the government’s alcohol strategy, and the evidence linking excessive alcohol consumption to less productive student learning, further discussions are needed to enhance this work in a more coordinated and sustainable way.

Recommendations

On the basis of this research, the following recommendations may be made:

Every HEI should have a comprehensive alcohol policy which is accessible and visible to all students and staff. There are many examples of good policy documents available; however, plans to implement these need to be addressed. Integrating individual institutional policies with city and local authority approaches may be beneficial, and is a process which could be facilitated locally. The approach originally taken by the national Teaching Public Health Network (TPHN) provided an opportunity to develop a regional alcohol strategy across the HEI sector.²⁶ The national TPHN, although no longer in existence, was led from a central office at the Department of Health which, in collaboration with the Healthy Universities Network, could lead on a national alcohol strategy across the HEI sector.

Further partnership and community involvement in the development of initiatives is needed. The use of their student volunteers to facilitate work related to sensible drinking amongst students could be extended more widely and would increase student ownership and involvement in intervention design and administration.

A more robust evidence base needs to be developed around alcohol initiatives targeted at students in higher education. Realistic evaluation studies focused on assessing the impact of these public health interventions on students’ health, wellbeing and academic achievement are urgently needed.

Raising awareness of competing interventions within the same institution and their perceived effectiveness is important if duplication of effort is to be avoided.

Staff training and education around safer, sensible and social drinking cultures within HEIs needs to be more consistent and supported more centrally.

The involvement of commercial interests in the promotion and supply of alcohol to HEIs needs clarification and would benefit from independent guidelines. Guidance and support for students’ unions in dealing with the issues involved would be valuable nationally.

Future work should look towards a nationally coordinated approach to promoting a safe, sensible and social drinking culture within HEIs. Through the sharing of good practice regionally and nationally, this agenda could influence the health and wellbeing of thousands who work, study and live within a university community. These factors also impact on the universities’ role in promoting and implementing their corporate and social responsibility agenda.

Conclusion

This study identifies the need for further research and development in the area of sensible drinking. It raises many questions and highlights areas where evidence is lacking. Locally coordinated public health initiatives focused on sensible drinking could use examples of best practice already in place to support a national healthy university strategy.

The issues and education associated with promoting safe and sensible drinking habits extend beyond the physical and time boundaries of universities. University students are future leaders and policy-makers, and their learning and experiences will inform future policies which in turn will impact on future populations. For these reasons, higher education is a key setting in which to explore how sensible drinking patterns can be facilitated and embedded in people’s lifestyles. It is hoped that this account of one region’s experiences will contribute to the ongoing debate about how to support and embed sensible drinking patterns into people’s lifestyles.

Footnotes

Acknowledgements

We would like to extend our thanks to all contributors from higher education institutions across the South West of England who spent time completing the pro formas which provided us with the information for the case studies contained within the report.

Funding

We would like to acknowledge support from Association of Higher Education Institutions in the South West (HERDA-SW; now Universities South West) for providing us with the funding to conduct this piece of research.

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