Balancing Alcohol’s Traditional Cultural Role with Increasing Public Health Concerns

Ian M. Newman, PhD The Wesley C. Meierhenry Professor The Wesley C. Meierhenry Professor Director of Nebraska Prevention Center for Alcohol and Drug Abuse Director of Nebraska Prevention Center for Alcohol and Drug Abuse Department of Educational Psychology Department of Educational Psychology University of Nebraska-Lincoln (USA) University of Nebraska-Lincoln (USA)

There is no doubt that beverage alcohol has the potential to contribute to significant problems for us as individuals, families, communities and countries. There is no doubt that beverage alcohol has the potential to contribute to significant problems for us as individuals, families, communities and countries. There is also no doubt that customs involving alcohol use have played important roles in societies for centuries. There is also no doubt that customs involving alcohol use have played important roles in societies for centuries.

Review 1. Traditional, cultural roles of alcohol 2. Changes in public health approach to prevention 3. Balance between alcohol’s traditional role and preventing alcohol-related problems 4. Data from a community that reduced high-risk alcohol patterns

3 Fundamental Issues 3 Fundamental Issues Alcohol use is associated with pleasure Alcohol use is associated with pleasure Policies must have wide public support Policies must have wide public support Education will be an integral part of any program Education will be an integral part of any program

The traditional roles of alcohol in a society

New (non-traditional) uses of alcohol, culturally unconstrained drunkenness to pass the time mood modification taste sociability food enhancement celebration hospitality medicine religious ceremony Traditional uses of alcohol, culturally constrained HIG H RIS K LO W RIS K

New Public Health Can’t always eliminate the cause Can’t always eliminate the cause Reduce risk Reduce risk Reduce harm Reduce harm

Traditional use, culturally constrained Not a traditional use, few constraints High Risk Low Risk Balancing Risks with Cultural Traditions

Balancing Tradition with Risk: An Example The Problem: How to reduce alcohol-related problems at a university The Problem: How to reduce alcohol-related problems at a university Students line up to get into one of dozens of bars near university campus

Balancing Tradition with Risk: An Example Community Coalition Community Coalition Open, with wide involvement Open, with wide involvement

Four Work Groups Education and Information Education and Information Social Environment Social Environment Neighborhood relations Neighborhood relations Policy and enforcement Policy and enforcement

Examples of objectives Decrease the number of students younger than age 21 who reported drinking in bars from 21% to 16%. Decrease the number of students younger than age 21 who reported drinking in bars from 21% to 16%. Increase by 25% the number of students attending alcohol education programs. Increase by 25% the number of students attending alcohol education programs. Increase by 15% the number of alternative entertainment options available to students. Increase by 15% the number of alternative entertainment options available to students.

Results: Drinking Problems at University

Results Drinking & driving by university students Drinking & driving by university students

Students who do not drink alcohol experience alcohol- related problems Students who do not drink alcohol experience alcohol- related problems Results:

Lessons Learned Know the problem (good epidemiology) Know the problem (good epidemiology) A logic model A logic model Awareness Awareness Policy change Policy change Enforcement Enforcement Leadership Leadership Consistency Consistency

Lessons Learned, continued Inclusive Inclusive Publicity (example) Publicity (example)

Lessons Learned, continued Evaluation Evaluation

Balancing Alcohol’s Traditional Cultural Role with Increasing Public Health Concerns

Two Options Identify high-risk patterns of alcohol use and control them Identify high-risk patterns of alcohol use and control them Reduce overall per capita alcohol consumption Reduce overall per capita alcohol consumption

Two Options Identify high-risk patterns of alcohol use and control them Identify high-risk patterns of alcohol use and control them Reduce overall per capita alcohol consumption Reduce overall per capita alcohol consumption

Plan Goals Goals Objectives Objectives Methods and strategies Methods and strategies Timetable Timetable Who is responsible for each task Who is responsible for each task