Drink less or drink slower: the effects of instruction on alcohol consumption and drinking control strategy use
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Drink less or drink slower: the effects of instruction on alcohol consumption and drinking control strategy use.

Sugarman D.E., Carey K.B.
Psychology of Addictive Behaviors: 2009, 23(4), p. 577–585.
Unable to obtain a copy by clicking title? Try asking the author for a reprint by adapting this prepared e-mail or by writing to Dr Carey at kbcarey@syr.edu. You could also try this alternative source.

What happens when instead of asking students to cut drinking, you ask them to use more moderation strategies such as spacing or avoiding heavy drinking situations? The results of this US study suggest that changes in strategy use may bear little relation to changes in drinking, and that intention to cut back is the most important factor.

Summary Studies have not consistently found that teaching college students strategies to moderate their drinking are actually followed by less drinking, and students who use these strategies more intensely do not necessarily drink less. Such strategies include spacing out drinks, drinking slowly, refusing drinks or spirits in particular, eating before drinking, finding non-alcoholic alternatives, and avoiding drink-promoting situations. Some studies have found that moderate use of such strategies is associated with less drinking than using them very little or very much. On the other hand, at least one study found that mailed feedback on their drinking did curb college student drinking, and seemingly did so because it promoted the use of protective strategies.

The featured study at a US college sought to clarify the relation between strategy use and drinking by instructing students to either use more strategies or to drink less. Issues addressed included whether using more or certain kinds of strategies would reduce drinking, and whether more and what types of strategies were used when the student was trying to cut down.

The study recruited 177 mainly female and campus-resident college student drinkers aged at least 18. At first they reconstructed the amount they had drunk over the past two weeks as a baseline against which to assess whether in the following fortnight they changed the amount they drank. During the fortnight all were asked to record each day how much they had drank and what moderation strategies they had used. Following the initial assessment, they were allocated at random to merely conduct this monitoring, or additionally to an instruction to over the next fortnight halve the amount they drank, or to double their use of a list or moderation strategies. Over 80% returned to be re-assessed at the end of the fortnight.

Main findings

At baseline, across all students the more often they used strategies to avoid drinking (like refusing drinks or spirits) on average the less they drank, while those who used more strategies to moderate the effects while actually drinking (such as drinking slowly or eating before and during drinking) drank more.

The instructions they then received did alter both drinking and strategy use as intended. Asked to cut their drinking, 68% did so to some degree but just 50% asked merely to monitor their drinking. Asked to increase strategy use, 84% did so to some degree but just 55% asked merely to monitor their drinking.

However, there were clear drinking reductions only among the students directly asked to drink less. Only they reduced their average weekly intake to a statistically significant degree, and only they did so more than the students asked merely to monitor their drinking. Also, only they reduced their estimated average and peak blood alcohol levels.

Of the different types of strategies, avoiding drinking, moderating effects while drinking, and participating in non-alcoholic leisure time activities were all increased most by the students specifically asked to do so. Only the first type – avoiding drinking – was increasingly adopted by students asked directly to drink less.

Changes in how often students deployed these strategies were however unrelated to changes in their drinking, and this was the case across all students and within the groups asked either to cut back or use more strategies.

The authors' conclusions

Instructions to reduce drinking had the intended effect, largely because students reduced how much they drank when drinking heavily. As other studies have found, this shows that college students can and will voluntarily reduce their alcohol use even in the absence of incentives to do so. More often avoiding situations where heavy drinking might occur was the way they sought to cut back, though there was no evidence that this did actually cut their drinking. Asking students instead to used more strategies to moderate or avoid drinking also had the intended effect, but no impact on drinking itself. The implication seems to be that promoting drinking control strategies alone is unlikely to reduce drinking unless the student actually intends to cut back. Instead the combination of trying to reduce alcohol use and using avoidance strategies may be more effective than exhortations to increase strategy use in general.

Last revised 13 January 2012

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