When it comes to alcohol, our health promotion efforts have traditionally attempted to scare people. It's time for a new approach, writes Patrick Kenny
Recently released statistics showed that 16 per cent of Irish women binge-drink once a week. It is a serious problem with serious consequences. But what impact does the way we present these statistics have on our behaviour? Turn the figures on their head - if 16 per cent binge-drink it means that 84 per cent don't. Could emphasising this positive statistic potentially hold the key to changing behaviour?
Cultural and peer influences are at the heart of how we behave, and these peer factors have a particularly powerful impact on teenagers who desire to fit in with their peers. What parent hasn't been told that "everybody else is doing it" when confronting their children about some problematic behaviour? In a certain sense, this is precisely the source of the problem - "everybody" is not doing "it", whatever "it" happens to be.
Our perception of the social norm - those behaviours and attitudes that are both common and socially acceptable in a peer group - have a significant impact on our actions. For example, teenage girls who read celebrity magazines consistently tend to hold a more negative body image than those who do not. Their perceptions of the "normal" female body affect their body image and, too often, their dieting behaviour.
The interesting thing is that we tend to misperceive this norm, almost always by overestimating the frequency of the problem in question. We also inadvertently contribute to these misperceptions in our conversation.
How many of us go to work on Monday morning boasting about how restrained and sober we were at the weekend? How many of us comment on how well behaved the local teenagers were in town on Friday night? We easily misperceive the norm when coffee break conversation invariably revolves around how bad things are.
"Bad behaviour", because of its shock value, is memorable and we tend to generalise it and assume that it describes more people than it really does. This misperceived norm becomes the standard against which expected behaviour is measured, contributing to an already strong peer pressure. As more people behave in this way, the peer pressure increases further and a kind of vicious circle ensues.
Many of our strategies for dealing with social ills fall into this trap. Consider a recent American anti-smoking advertising campaign which featured the following messages on billboards: "3,000 kids start smoking every day" and, on another billboard, "Age 7 - first hamster; Age 9 - first bike; Age 11 - first cigarette". The aim of the campaign was to scare parents into recognising how young children were when they started smoking - a laudable aim given the serious health consequences of smoking. It had, however, an unintended side effect: it told 11-year-old children that "everybody's doing it". After all, 3,000 of them took up the habit every day, so what's the big deal?
We are not immune to these unintended side-effects in Ireland. Our health promotion efforts have traditionally attempted to scare people into good behaviour. Some recent Irish initiatives - such as an advertisement showing a drunken girl vomiting - certainly have a place in health promotion. But they may also reinforce a misperception of the norm.
Heavy-drinking teens see people vomiting on the streets all too often, and, while it is unpleasant at the time, they realise that there are often no more immediate negative consequences once the hangover wears off.
However, the graphic image of someone vomiting stays in the mind and, because we don't remember those who drink sensibly and walk home in a straight line, it can help feed the mistaken generalisation that "everyone" gets drunk.
Instead of focusing on fear, perhaps we should try to focus on normalising the positive behaviour that already exists?
This approach has been attempted with some success in the United States. A number of American colleges and high schools have conducted social norms campaigns to correct misperceptions about the rates of alcohol consumption by highlighting how much the average student actually drinks, an amount that is always less than what people perceive their peers to drink.
Correcting this misperception can help reduce the pressure to drink, and, as people begin to drink less, a kind of virtuous circle can ensue, with perceptions of consumption and actual consumption decreasing hand in hand.
It sounds too easy to be true, and to an extent it is. It is hard to devise such a campaign and to preserve it from contamination from other pro-drinking influences like alcohol advertising. But while not everyone is in agreement about the effectiveness of the approach, the balance of evidence indicates that it works.
There are a handful of studies questioning this strategy, but several dozen indicating impressive results - some college campuses have seen reductions in dangerous drinking of more than 25 per cent within two years.
Gay Byrne and the new Road Safety Authority might also want to take note: there is evidence that this approach can help change behaviour on a wide range of issues, including road safety.
Would such an approach work in Ireland, where the culture is different from in the US and where normative amounts of alcohol consumption are much higher? Theoretically it should, but at the very least there is a need for funding to research the concept.
The glass isn't always half-empty - it is also half-full. We shouldn't pretend problems don't exist, but we also need to highlight good examples where we find them. Accentuating the positive rarely sells papers, but it could save lives.
Patrick Kenny is a lecturer in marketing in the Dublin Institute of Technology - Pat.Kenny@dit.ie