Abstract
Interventions aimed at reducing alcohol consumption and related harms among college students are varied in number and type. While there are many studies examining the efficacy of such interventions (Larimer & Cronce, 2007; Lewis & Neighbours, 2006; Smart et al., 2018; Toomey et al., 2007), as well as the determinants of college student drinking (Dantzer et al., 2006; Supski et al., 2017), there is less research on students’ own views on these interventions and on student drinking more generally.
Among the studies that do exist, the findings suggest that students are often sceptical of or ambivalent about such interventions (Davies et al., 2018; Furtwängler & de Visser, 2017; Hutton, 2012; Larsen et al., 2016). A study by Hutton (2012), for instance, found that college students were sceptical about the extent to which harm reduction campaigns would change student drinking patterns, and that they prioritised pleasure over the negative consequences of alcohol consumption. Research by Davies et al. (2018) found that students seemed resistant to change, viewing measures seeking to increase awareness of harms as being insufficient to bring about change or as liable to be ignored or deemed irrelevant.
The sense of scepticism or ambivalence noted in the above studies has considerable implications for alcohol prevention efforts in the college sector. De Visser et al. (2013) contend, for example, that ambivalence or resistance toward interventions can be poorer predictors of behaviour than are homogeneous attitudes. Ambivalence may also prove challenging for message targeting, the authors argue, as messages emphasising negative aspects may be dismissed or reframed to support drinking motives. Against this background, there is growing consensus that eliciting and addressing the views of the target audience should constitute a crucial part of good intervention development to ensure that interventions are engaging, relevant and useable (Baker et al., 2014; Yardley et al., 2015; Larsen et al., 2016).
Recognising the importance of this factor, this qualitative study aims to add to the currently limited research in this area by examining college students’ perspectives on alcohol prevention measures and consumption more generally in the context of a pilot alcohol prevention programme for college students in Ireland, 1 known as the REACT (Responding to Excessive Alcohol Consumption in Third-level) programme. It is intended that findings from this qualitative study will form part of the evaluation of the REACT alcohol programme. Since REACT is at the pilot stage, it was deemed important to capture students’ perspectives on the programme to help inform future configurations of this programme. As Yardley et al. (2015) highlight, understanding the needs and perspectives of the target population is vital for good intervention development. Moreover, in order to design effective interventions, it is important to understand the motives and drivers behind excessive alcohol consumption in the target population (Coleman & Cater, 2005; de Visser et al., 2013; Van Damme et al., 2013). Ogenchuk (2012) (pp. 157–8) further contends that “t(T)he students themselves should be the main source of data collection when exploring programs for alcohol prevention since they are the target group and ‘it is the young that are most knowledgeable about their own behaviour’ (WHO, 1993)”.
Policy context and programme overview
National context
Student drinking occurs against the backdrop of a wider alcohol policy context. In Ireland, the national policy context has been marked by deregulation and liberalisation of the alcohol industry in recent decades, which has led to increased availability, affordability and cultural normalisation of alcohol consumption (Butler, 2009; Calnan et al., 2018). It is estimated, for example, that between 1998 and 2010 there was a 161% increase in the number of full off-licences selling alcohol in Ireland (Alcohol Action Ireland, 2016). Viewing Ireland’s alcohol policy through a wider political lens, a number of commentaries have defined it as being markedly neo-liberal in its orientation (Butler, 2009; Calnan et al., 2018; Mercille, 2016) and “specifically antipathetic to the idea that the state should interfere directly in the alcohol market” (Butler, 2009, p. 343).
Such developments have been accompanied by a significant increase in alcohol consumption: between 1970 and 2003, alcohol consumption doubled in Ireland at a time when consumption was falling in most developed countries (Byrne, 2010). While per capita consumption levels in Ireland have dropped in recent years from a peak of 14.3 litres of pure alcohol per person aged 15+ in 2001 to 11 litres in 2018, it is forecast that the percentage of Irish people who drink will increase by 2030 even though per capita consumption may decrease (Manthey et al., 2019).
The culture of intoxication evident in Ireland and other Western countries is also reflected in alcohol-related findings for the country’s college student population. The 2002–2003 College Lifestyle and Attitudinal National (CLAN) Survey in Ireland, for example, concluded that a pattern of high-risk drinking was now the norm among college students (Hope et al., 2005). A study (Davoren et al., 2015) conducted at one large Irish college found that approximately two-thirds of the students were drinking at hazardous levels, with similar levels noted for female and male students.
The significantly high alcohol consumption levels reported among college students in Ireland have persisted against the backdrop of a liberalised alcohol policy context. Policy developments in more recent years, however, signal a change in direction marked by the enactment of the country’s much-debated Public Health (Alcohol) Act 2018 (Government of Ireland, 2018). This Act contains a number of key policy measures, most notably minimum unit pricing (MUP) for retail of alcohol products, along with restrictions on the marketing and advertising of alcohol, and structural separation of alcohol from other products in mixed trading outlets (Government of Ireland, 2018). The Act is deemed a “legislative milestone” by its proponents (Collins, 2015) and suggests, perhaps for the first time, that state alcohol policy in Ireland seems more aligned to public health considerations than to those of the alcohol industry (Calnan et al., 2018). This shift in policy direction followed increased pressure by Ireland’s public health community, who for several decades have advocated for more stringent alcohol measures through various policy documents and research reports (Calnan et al., 2018).
Calls for a policy shift and stricter alcohol regulation in Ireland have not gone unheeded either by the country’s college sector, particularly following a number of alcohol-related student fatalities (e.g., Roseingrave, 2010). In 2001, for instance, Ireland’s Minister for Health launched the Framework document for developing a college alcohol policy, in response to college authorities’ concern regarding “alcohol promotion practices on campus, high-risk drinking among students, and the impact of this drinking pattern on student academic achievement, student personal problems and student attrition” (Department of Health & Children, 2002, p. 3). On foot of this document, many colleges around the cuntry developed their own institutional alcohol policies based on this framework. Other notable developments included the decision by the Union of Students in Ireland (USI) in 2013 to disassociate itself from Drinkaware (USI, 2013), an industry-sponsored alcohol awareness foundation established as a charity in 2006 (McCambridge et al., 2014). The USI further committed to collaborating only with non-industry-funded partners in delivering future alcohol interventions targeting students. Despite these developments, there has been no coordinated, sector-wide initiative in colleges in Ireland until now aimed at addressing student alcohol consumption, and measures have tended to be ad hoc and single-institution-led.
The REACT alcohol programme
The REACT programme has sought to address this gap by providing a standardised suite of measures that third-level colleges nationally can implement, and it is the first programme of its kind in Ireland. Co-funded by the country’s national health service, the Health Service Executive (HSE), and an Irish-based philanthropic trust, the programme was developed in 2015 and launched in 2016. The protocol for the development and evaluation of this programme is outlined in a separate article (see Davoren et al., 2018).
REACT consists of a suite of mandatory and optional action points that participating colleges are required to implement and for which they will receive an award and accreditation on successful implementation to recognise their efforts and incentivise participation. The award consists of certification and a REACT flag presented at a formal ceremony in recognition of the college’s implementation of the programme, and to date approximately 10 colleges in Ireland have received this award. To achieve certification, colleges are required to implement the programme’s mandatory action points and a specified minimum number of optional action points. Mandatory action points include setting up a dedicated steering committee comprising staff, students and local police, council and drugs taskforce representation, developing or revising the college alcohol policy in line with the national framework, requiring a proportion of incoming students to complete an online brief intervention tool, and securing a three-year commitment from the president of the college to actively pursue the action points. Optional action points include providing alcohol-free housing and social spaces, providing late-night transport to students, mapping local licensed premises in the area, providing class rep training on alcohol-related safety information, and establishing a visible and accessible referral pathway for alcohol services for students (Davoren et al., 2018).
REACT conforms to a harm minimisation approach that acknowledges the need for environmental change rather than solely prescribing individual-oriented measures. This includes ensuring cross-campus support for tackling student alcohol consumption, developing partnerships with the wider community, and addressing the physical environment such as the density of alcohol outlets in the surrounding community and availability of alcohol-free accommodation on campus.
Theorising student alcohol consumption
The reasons why considerable proportions of college students drink excessively are varied and complex. Aspects of the college campus environment, such as substantial amounts of unstructured time and student-oriented alcohol advertising, may contribute to increased drinking, for instance (NIAAA, 2002). Moving into higher education is also considered a “transitional period”, a time of change, when students shift from one constructed identity to another, bringing shifts in culture, identity, roles, routines and relationships (Awang et al., 2014). It can also be a time of significant developmental change, moving from adolescence into adulthood, where the desire to develop a coherent sense of identity separate from those of parents or peers is predominant (Brady et al., 2018; Lalor et al., 2007).
Part of that identity and cultural shift may involve increased use of alcohol and other substances. It has been argued, for example, that binge drinking is a mark of youth reaching autonomy from their parents, with alcohol consumption cited as one of the “rituals of maturing” (Demant & Järvinen, 2006; Larsen et al., 2016). Elsewhere, McCabe et al. (2007) cite cultural acceptability of substance use and peer pressure, as well as the academic and other pressures faced by students, as possible reasons college students may resort to increased substance use. Supski et al. (2017) meanwhile conceptualise college drinking as a social practice comprised of a “bundle of activities” that operate together to reinforce excessive consumption and describe drinking as “an organising principle of university social life” (p. 228).
The emphasis on drinking as a social practice underlines a further potential driver of student drinking – the desire for social bonding. Fry (2010), for instance, contends that the pursuit of “determined drunkenness” (Measham, 2006) enables opportunities for social interaction and building a sense of belonging among young people. Socialisation and drinking have become so intertwined, she argues, that drinking is viewed by many young people as an end in itself – to the extent that “intoxication has become a powerful and arguably dominant norm among young people’s social activity repertoire” (Fry, 2010, p. 1281).
This does not mean, however, that student drinking is necessarily a homogenous activity. Research by Davoren et al. (2016), for example, describes a typology of drinkers rather than one single type of drinker, categorising college students as the guarded drinker, the calculated hedonist, the peer-influenced drinker and the inevitable binge drinker. Fry’s (2010) study on young people more broadly points to narratives of responsible alcohol consumption or abstinence and heterogeneity when manoeuvring within intoxicated social spaces.
The variety of explanations for, and experiences and perceptions around, student drinking underline the complex nature of this issue and the multiple layers of influence that potentially drive alcohol consumption among college students. Indeed, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2002) asserts that college student drinking is the product of many factors, and states that “because there are multiple reasons for excessive drinking, multiple points of intervention are needed to address them” (p. ix).
A social-ecological perspective
Against this background, this study acknowledges the benefits of viewing student alcohol consumption within the framework of a social-ecological model, a comprehensive approach used to explain human behaviour (Bronfenbrenner, 1979; McLeroy et al., 1988). The Centers for Disease Control and Prevention (CDC) (2002), for example, uses a four-level social-ecological model as a framework for prevention, defining it according to societal-, community-, relational- and individual-level influences.
Viewing student alcohol consumption within a social-ecological framework acknowledges that both the causes of and solutions to excessive drinking among college students require a comprehensive approach addressing the different levels of influence. Individual factors may include, for example, students’ age, nationality or beliefs that college is a socially expected time to engage in heavy drinking. Relational factors may include peer group or family influences on alcohol-related behaviours. Community influences could include factors such as the density of alcohol outlets in the surrounding area, but also the college setting itself and institutional policies related to alcohol. Societal influences include national policy regarding alcohol regulation, but also the wider social order. In their research on young people’s drinking, for instance, Griffin et al. (2009) refer to the prevailing “neo-liberal social order” (p. 460), whereby on the one hand the economics and culture of neo-liberalism promote young people’s “intensified alcohol consumption” (p. 470), while at the same time requiring young drinkers to be discerning, responsible neo-liberal subjects capable of self-regulation.
Given the variety of explanations for and potential drivers of student alcohol consumption cited above, this study recognises the utility of adopting a social-ecological lens both in terms of understanding the potential causes of hazardous drinking among college students and in addressing the issue through alcohol prevention measures or programmes.
Methods
Study design
A qualitative focus group study was undertaken with students at two colleges taking part in the REACT programme in the period February to April 2018. Ethical approval for the study was granted by the college Social Research Ethics Committee. At the start of each focus group, the facilitator provided the participants with an overview of the REACT programme and a copy of the REACT action points. The students were then allowed time to look through the action points before the focus group discussion commenced. The topic guide included questions on what the students thought of the programme, what measures they would take to reduce hazardous drinking, and what their views were on college drinking more generally. It was ensured that the researcher conducting the focus groups for this study was skilled in moderating groups, conducting them in an inclusive and non-judgemental manner, and that they were unknown to the students, ensuring impartiality.
The decision to use focus groups in this study was founded on the desire to examine how students collectively “made sense” of the alcohol issue. In the focus group setting, participants are encouraged to interact with each other and not merely respond to the moderator – in this way, the range and complexity of attitudes and beliefs can emerge (Dilshad & Latif, 2013; Gorman & Clayton, 2005). Moreover, focus group research has shown that people may be more, rather than less, likely to self-disclose or share personal experiences in group rather than dyadic settings (Farquhar, 1999).
Sampling method
Purposive sampling was used to select the focus group participants and sites based on two criteria – type/location of the college and category of student. Regarding the first sampling criterion – the institution – one large university in an urban setting (college 1) and one smaller institute of technology in a regional location (college 2) were selected to allow for variation in terms of type and location of institution. As noted earlier, Ireland’s higher education sector consists of universities, institutes of technology (ITs) as well as colleges, located in different parts of the country. Including more than one type of institution in the study was therefore an important consideration. Moreover, in the context of a social-ecological framework it acknowledges the importance of the college setting, a community-level factor (CDC, 2002), as a potential influence on student drinking.
For the second criterion – type of student – four types of student were selected for the individual focus groups: young undergraduates, mature students, international students, and students who are members of a club or society. The focus groups were organised by student type rather than being mixed. The decision to include four types of student was informed by research undertaken as part of the wider evaluation of REACT. A baseline study on alcohol consumption levels among college students in Ireland found differences in consumption levels based on age and nationality of students, with younger Irish students often showing higher levels of consumption compared with mature students and non-Irish students. Elsewhere, in qualitative research undertaken on implementation of the REACT programme, participants pointed to potential differences in consumption levels and patterns among students who are members of a club or society. The study therefore sought to capture a variety of views from students by sampling students according to these four categories at the two study sites.
Participants
Participants for the focus groups were recruited through contacts with each institution. The individual focus groups varied in size, depending on availability and willingness of students to turn up to the group, and all groups consisted of a mix of male and female students. A total of 51 students took part in the focus groups overall, comprising 20 males and 31 females. While a more equal gender balance was desired, the challenges faced in recruitment and the fact that the researcher had to rely on institutional contacts to recruit the participants meant that they had less control over this aspect. The authors acknowledge that a higher number of females than males may skew the study findings somewhat, although the excerpts contained in the Results section aim to provide a good balance of male and female comments.
In terms of nationality, 10 different countries were represented in the sample: Canada, China, India, Ireland, Jamaica, Latvia, Nigeria, Poland, Romania and Sudan. Most of the students from non-Irish countries indicated that alcohol consumption was permitted in their country. Students in the clubs and societies groups varied in terms of the type of club/society with which they were affiliated, ranging from sports clubs to arts-based activities. In the mature students’ group, the age range broadly spanned those in their late 20s/early 30s to those in their 40s/early 50s, while those in the young undergraduate age group were aged 18 to 22 years.
Data analysis
Data for the study were analysed using thematic analysis in line with the Braun and Clarke (2006) six-phase guide to undertaking thematic analysis, which offers a clear and useable framework for such analysis. Thematic analysis is described as a flexible and useful research tool, which can potentially provide a rich and detailed, yet complex, account of data (Braun & Clarke, 2006). A particular aim for this study was to go beyond mere surface descriptions and to gather more “nuanced and complex interpretations of data” (Clarke & Braun, 2013, p. 123). Since the topic of alcohol in particular has the potential to generate ambivalent attitudes and varied responses from students, capturing such nuances and potential contradictions was deemed especially important, and thematic analysis offered an ideal approach to undertake such a study.
For this study, all focus groups were audio recorded and transcribed verbatim. Transcriptions were imported into NVivo software (version 12) where initial codes were generated using inductive coding, yielding a list of 56 nodes to begin with. This initial list was further grouped into categories using mind maps visual display. A second researcher (MD) reviewed these categories and discussed potential themes until consensus was reached. Initial themes were subsequently reviewed and refined, yielding three main themes, which are outlined below.
Results
Three key themes were identified based on analysis of the findings, namely: perceptions of student drinking, importance of the lived environment, and responsibility for controlling student drinking. Participants’ names have been replaced by pseudonyms in the excerpts that follow.
Perceptions of student drinking
The first theme of this study relates to participants’ perceptions of student drinking. A number of sub-themes were further categorised under this overarching theme, as expounded in the sections below.
Pervasiveness of alcohol
From the outset, there was a strong sense among the student participants that alcohol was endemic to college life. Students attributed this to different factors. Some participants emphasised individual-level factors, such as the social expectation or belief that college life is synonymous with going out and drinking alcohol and that “students are going to drink regardless” (Luke, clubs/societies, college 1). Engaging in heavy drinking was deemed by some as an almost inevitable rite of passage for students, a symbol of their new-found independence, one of the “rituals of maturing” (Demant & Järvinen, 2006): Drinking is a rite of passage for college students – because it’s their first time away from home and they get to break out. (Abigay, international, college 2)
Another student, a self-professed frequent drinker, cited community-level factors – specifically, the easy availability of cheap alcohol in supermarkets, stating that this was leading to more at-home drinking rather than drinking in bars either on or off campus: When you go to Tescos, you’re actually drinking more than what you are in the pub. We can get 10 bottles each for the same price as a few pints. And it’s stopping people going out drinking. (Tom, undergraduate, college 2) I went to the pub with a few Irish locals. And they’re just hitting it back and it’s nothing. (Chano, international, college 2) The pubs…because there’s one place in particular here, and there was like school kids going in there. (Martha, mature, college 2)
Transient nature of drinking
While alcohol consumption was perceived by the majority of students as being endemic to both student life and Irish culture, the drinking culture deemed synonymous with student life was also seen by many of the students as a transient phase. There was a belief that heavy drinking occurred only during certain periods of college life, implying that student drinking is not necessarily static, but dynamic and changing. For some of the younger students, there was a strong sense that college was a time-limited phase and that students should make the most of this time by having fun and going out drinking: Even going to school like, you ask any of our teachers – the first thing they’ll say is like, oh we’d some nights, the best nights, the best times you had were there [college]. (Tom, undergraduate, college 2) I don’t go out [drinking]. (Rachel, mature, college 1)
More surprising was the admission by a few of the younger students that they “don’t drink at all” (Hannah, undergraduate, college 2) or would only “drink now and then” (Alan, undergraduate, college 1). When asked whether they felt pressurised to drink or stigmatised, some indicated that they did not: “It’s not really a mandatory kind of thing. If you want to show up, the lads will be there – it’s kind of individuals’ own choice” (Mark, clubs/societies, college 2). In addition, at both focus group sites, a number of students involved in clubs and societies pointed to a slight shift in more recent years toward non-alcoholic events at their college: Particularly in recent years, it’s more acceptable within certain societies not to drink – and people are having non-alcoholic socials. (Caroline, clubs/societies, college 1)
An intractable problem
The participants’ perceptions of student drinking appeared to influence their views on college alcohol prevention measures and the REACT programme more specifically. On the one hand, because there was virtually unanimous agreement that alcohol was pervasive in college life and wider Irish society, most students conceded that there was a need for alcohol prevention measures. However, there was a significant sense of doubt or scepticism that programmes such as REACT would work in practice.
Some students attributed the perceived lack of potential impact to the displacement effect that would inevitably occur if campuses clamped down on student alcohol consumption: The college can’t control this – how can they know what you’re doing when you’re leaving the building. They don’t know if you’re going to come back the next day hungover or not. (Irka, international, college 2) Well I think just the whole thing of addressing the alcohol problem is difficult in Ireland because as a nation we just drink. (Kevin, clubs/societies, college 1) That’s what most people do like – drink a load at home and then go out and you don’t have to really spend much on drink. (Michael, undergraduate, college 2) You could close a house party down in one location, but another one will be starting up like 15 minutes away. (Luke, clubs/societies, college 1) It’s good like for people who drink every day. (Stephen, undergraduate, college 2) It’s only if it’s affecting your life in other ways – if you’re not going to training or missing college. (Michael, undergraduate, college 2)
Importance of the lived environment
A second theme identified in this study was the importance of the lived environment for students. Thus, while students were sceptical about the potential impact of programmes such as REACT to reduce student drinking, many of the students viewed the proposal to provide alcohol-free spaces as one of the stand-out positive action points of the REACT programme: As far as positives, I think the idea of an alcohol-free social space is a fantastic idea. (Kevin, clubs/societies, college 1) The alcohol-free accommodation that was voluntarily offered to students. I think that’s a great step because I’m not sure about every student – whether they really want to be in around that environment. (Beth, mature, college 1) Things to do in the evening – there’s nothing to do like. And everything that’s to do like, it’s gonna cost you about 15 quid like whatever it is. (Tom, undergraduate, college 2) Where I’m from, we have basketball courts, soccer pitches available so you can go and play…But here you have to pay to use it. (Chano, international, college 2) Maybe that’s another problem, cos here the coffee shops close at six. In my country, the closing time is 10 or later. I suppose the pub is the only place they can go in Ireland. (Prisha, international, college 2)
While many students underlined the lack of alternative spaces in which they could socialise or unwind, some of the younger Irish students emphasised the importance of the downtown pub or campus bar as a setting where they could socialise and connect with their peers – a place where they could “make friends on a night out…where you usually meet someone” (Tom, undergraduate, college 2). For them, nights out in the local pub or bar represented a space where they could have fun and forget about their worries: It’s that everyone’s out and you’re all doing the same thing like. Yeah, we’re not thinking about college like, we’re all just having a laugh and we’re all out together. (Rose, undergraduate, college 1)
While the importance of leisure spaces was strongly emphasised by the participants, the issue of safety was also raised. In this regard, a number of the students expressed their approval at the proposed measure to provide late-night transport to students, a further optional action point of REACT. Female respondents in particular raised the aspect of personal safety on a night out in this context: I think it would be better if some kind of transport was provided to those students who are not very sensible. I’ve seen so many students just like passed out on the streets and there’s nobody, even their friends bail out on them. (Kate, international, college 1)
Responsibility for controlling student drinking
A final theme of the study relates to students’ differing perspectives on whose responsibility it is to control student drinking, which in turn influenced the types of measures they proposed to address this issue. Exploring students’ perspectives on such aspects was deemed important in order to gain an insight into how they made sense of the issue and to help inform development of the REACT programme.
Emphasis on personal responsibility
With the exception of the mature students’ groups, many of the students believed it was primarily the responsibility of the student alone to control their own drinking. Such a view sat in marked contrast to students’ perception that alcohol was endemic to the wider culture in Irish society and despite acknowledgement of environmental influences. The emphasis on personal responsibility and adulthood was strongly highlighted in this regard: We’re adults here – we’re the ones who decided we want to go to college, not our parents. (Piotr, international, college 2) It’s up to the student to actually seek that help. If they have a problem, it’s their own doing. (Ian, clubs/societies, college 1) It is trying to incentivise the institution, but it does not give any incentives to the student to stop drinking or to behave in a particular manner. So you should focus on the unit – the unit should be the person not the institution. (Yu Yan, international, college 1)
Given the emphasis on personal responsibility to control one’s own drinking, a considerable number of students highlighted the importance of individual-level solutions – in particular, raising awareness among college students about the harms of alcohol and its toxic effects. Such an approach implies that increasing students’ knowledge or awareness about alcohol’s harmful effects will help to change individual behaviour: There should be more emphasis on “alcohol makes you reckless”, “alcohol makes you stupid”, “it makes you sick” and “if you drink enough, it will kill you”. Like I still love to drink every so often…But you have to have more awareness on the negatives. (Kevin, clubs/societies, college 1)
The importance of individual students’ involvement in delivering and designing programmes like REACT was also raised. In this regard, a number of students underlined the importance of more diverse student involvement rather than solely involving students’ union representatives in such initiatives. The latter point was attributed to a belief that students’ union members were not necessarily representative of the “ordinary” student and tended to constitute a particular “clique” or more popular type of student: I think to an extent, while the Students’ Union does represent students, they very much are not like, let’s say a first-year student or a second-year student where the culture is very much different. (Paul, clubs/societies, college 1) I find the Student Union thing – like you’re either in that kind of demographic of people or you’re not…(Robert, mature, college 1)
Emphasis on college responsibility and wider environment
In contrast to the above views, many of the mature students believed that the college itself had a greater responsibility to address student alcohol consumption. As one mature student highlighted: “The person who’s actually active doesn’t see it themselves, they don’t realise how far it’s gone you know. So it takes someone to gently point out” (Helen, mature, college 2).
The need for the college to adopt more regulatory measures was particularly emphasised by those in the mature students’ group. Stricter enforcement of attendance was suggested, for instance, by requiring students to scan in their student card before lectures. The idea of a mandatory alcohol module for all students was also raised. Several participants suggested that college lecturers could play a greater role in monitoring students who may be frequently missing lecturers or arriving hungover to class, indicating support for greater surveillance and policing of students. Referring such students to a dedicated alcohol and substance officer was also suggested by one of the mature students: If for instance there are people who aren’t showing up for lectures after student nights – like a lecturer can take a note of who hasn’t shown up. And if it’s the same two or three people every week then, you know, the alcohol officer should be informed and maybe pull them to one side and maybe suggest a, reign them in. (Fiona, mature, college 2). They also have a responsibility, like say if they see someone walking out with car keys – they can be charged if that person gets in an accident and it was found out well you were drinking in their bar last night. And it’s the bartender who’s responsible, as opposed to the actual owner. (Grace, mature, college 1) Having the opportunity to live somewhere where you’re not disturbed. Like we’ve a few students on our course who don’t drink. They find it tough to get sleep and get study time and stuff like that because of the wild partying. (Susie, mature, college 2) I feel REACT, unfortunately it is a reaction to a problem. So I think it should be going back to education of younger people…Going into primary schools and teaching them there as well to, you know like, prevention is better than cure. (Grace, mature, college 1)
Discussion
This study has sought to explore college students’ perspectives on alcohol prevention measures and consumption in the context of the REACT pilot programme in Ireland. Acknowledging the reality that “very few studies explore what students think about reducing excessive drinking” (Davies et al., 2018, p. 4), the research seeks to address this gap and add to the limited evidence base by “giving voice” to student perspectives on measures aimed at tackling excessive drinking and on alcohol consumption more generally.
Findings from this qualitative study confirm that alcohol is perceived by the student participants as being pervasive to college life, an almost inescapable reality of the student experience. At the same time, the focus group participants acknowledged that this alcohol-saturated society extended beyond the grounds of the college campus, with many asserting that it was endemic to Irish culture itself. Viewing it within a social-ecological framework, participants seemed to collectively acknowledge the multiple layers of influence on student alcohol consumption. In line with the CDC’s four-level framework, for instance, they cited society-level factors (e.g., cultural normalisation of alcohol), individual-level factors (students’ expectation that college life was synonymous with drinking), relational influences (e.g., students’ desire for sociability and fun) and community-level factors (e.g., availability of cheap alcohol, lack of regulation in pubs, presence of on-campus bars).
Similar to other study findings (Davies et al., 2018; Furtwängler & de Visser, 2017; Hutton, 2012; Larsen et al., 2016), many of the participants were sceptical therefore of the potential efficacy of programmes such as REACT to tackle student drinking, owing to the inevitable displacement effects that may occur when alcohol is controlled in one environment but pervasive across the wider society. This includes the rapidly growing phenomenon of pre-drinking, which appears to be “universally associated with increased alcohol consumption during the evening and a higher risk of experiencing negative consequences, including alcohol poisoning, drunk driving and blackouts” (Labhart & Kuntsche, 2017, p. 136). A particularly strong finding from this study was the appetite or desire for leisure spaces that offered an alternative to these alcohol-infused environments. Moreover, while alcohol was deemed intrinsic to student life, the participants were not necessarily a homogeneous group in this regard, with some of the older students as well as a smaller cohort of the younger students stating that they consumed alcohol infrequently or not at all, while others viewed heavy drinking as a transitory phase.
Such findings raise a crucial point – the importance of addressing community-level factors, in particular the settings in which students interact, live and have fun. In line with Valentine et al.’s (2010, p. 19) assertion, it underlines the need for the development of “a wider range of mainstream leisure spaces which are less predicated on the consumption of alcohol”. Creating such alternatives, this study posits, could, on the one hand, serve to disentangle the strong association made between consuming alcohol and being sociable/having fun and, at the same time, cater for an increasingly diverse population of college students whose drinking preferences may be more variable than epidemiological statistics imply. In this context, and in line with Fry (2010, p. 1291), the study findings suggest that there may be a need for a certain “rethinking” of alcohol prevention therefore – “beyond a sole focus on intoxication and at-risk groups” and acknowledging that the varied interests of students extend beyond a mere predilection for consuming alcohol during leisure time. Indeed, students and young adults may be best placed to inform policy in this regard, not only in terms of creating alcohol-free leisure spaces but also in devising relevant and fun activities that provide viable, inexpensive alternatives to consuming alcohol.
Students’ desire for alcohol-free settings is borne out by other research conducted among college students. A study by Davies et al. (2018), for example, similarly highlights the lack of credible alternative socialising opportunities cited by students and the associated effects, such as the potential to “default to drinking” or feelings of stigmatisation among non-drinkers. The literature also points to greater heterogeneity in drinking among the college student population than is generally conveyed. Davoren et al.’s (2016) study, for example, describes a typology of student drinkers ranging from the guarded drinker, the calculated hedonist, the peer-influenced drinker and the inevitable binge drinker. Elsewhere, Fry’s (2010) study on younger adults sheds light on the experiences of infrequent drinkers and non-drinkers among this cohort.
While students seemed to implicitly recognise the need for a social-ecological approach to alcohol prevention, acknowledging the significance of society- and community-level influences as well as individual and relational factors, there was a divergence in perspectives when asked whose responsibility it is to control student alcohol consumption. Many of the younger students in particular viewed it as their personal responsibility to control drinking, while mature students frequently cited the responsibility of the college or bar owners in this regard. Such divergences in opinion further support the contention that the contemporary college student population is an increasingly diverse one, encompassing differences not only in terms of gender, nationality and socio-economic background but also in relation to possible generational differences. One potential explanation for this divergence in opinion is that the younger students may reflect the markedly neo-liberal social order into which they have been socialised, whereas older students may subscribe to a more paternalistic worldview, whether this is due to generational differences in outlook or their longer life experience.
Certainly, the emphasis on personal responsibility among the younger students, who at the same time acknowledged wider community- and society-level influences on student drinking, is interesting in this context. As stated earlier, it suggests that these students may embody one of the central tensions of the so-called “neo-liberal social order” (Griffin et al., 2009) – having to navigate a world where alcohol is ubiquitous and aggressively marketed but still perceiving themselves as self-regulating, responsible consumers. The emphasis on personal responsibility is also interesting in the context of the proliferation of “responsible drinking” campaigns. It suggests that messages of personal responsibility promoted in responsible drinking campaigns – now a common feature of alcohol-industry-funded corporate social responsibility (CSR) initiatives – may have become somewhat ingrained in the mindset of younger students, perhaps owing to their greater susceptibility to marketing or industry influences.
In keeping with the theme of the increased diversity of the student population, it is also interesting to note how participants in the study emphasised the need for greater and more diverse student involvement, particularly non-students’ union representation, in programmes like REACT. Such feedback is pertinent in the context of the growing emphasis placed more broadly on the importance of young people’s participation in policy and community development initiatives (Council of Europe, 2008). Studies also underline the benefits of the target group’s participation in decisions about the design and implementation of health promotion programmes (Reid et al., 2008; Simovska & Carlsson, 2012). Despite this commitment to participation, Griebler et al. (2017) contend that in practice it often remains purely rhetorical and that levels of participation are often rather low. The need to ensure more active participation by the target population is similarly borne out by this study, but with the added caveat of ensuring more diverse student involvement, outside of students’ union representation. Thus, in efforts aimed at increasing student participation in health promotion or harm reduction programmes targeted at this group, consideration of the types and not only quantity of students should constitute a priority for future programmes.
Finally, despite the growing diversity of the student population both terms of demographics and in relation to alcohol-related experiences and perceptions, this study contends that a common denominator among the majority of college students is the desire for sociability and connection with their peers in safe, fun and affordable environments. The participants’ responses bear this out: in particular, the strong emphasis placed on the need for a wider variety of leisure spaces that offer affordable, appropriate and engaging options to college students besides the ubiquitous “pub”. Even among the self-professed frequent drinkers in this study, the aspects of sociability and fun (“we’re all just having a laugh and we’re all out together”) were highlighted as the primary reasons for going out drinking.
This desire for sociability and connection is reflected in other youth-related research. Consultations for Ireland’s national recreation policy (OMC, 2007), for example, underlined young people’s desire for recreational spaces that are warm, safe, affordable and free from alcohol and drugs. The policy also recognised the significance of non-formal recreational spaces for young people, acknowledging that simply “hanging out” can be extremely valuable for building confidence and enhancing peer support networks among young people (OMC, 2007; Brady et al., 2018). Even in research on pre-drinking, one of the motivations cited for engaging in this practice is to facilitate socialisation with friends (Ferris et al., 2019; Labhart & Kuntsche, 2017; MacLean & Callinan, 2013). Elsewhere, research by Nolas (2014) on youth clubs shows that the young people were far less interested in the activities on offer and more interested in the opportunities provided by these activities to relate to each other and the youth workers. The author concluded that such “liminal spaces” need to be protected to ensure that young people can interact freely and “truly become themselves” (Nolas, 2014; Brady et al., 2018).
These and similar findings have significant implications for youth policy, including policies directed at college students and those seeking to reduce hazardous alcohol consumption. They suggest that in addressing the “intractable” issue of student alcohol consumption, college and policy stakeholders perhaps need to ask a different question: not how can they reduce excessive alcohol consumption, but rather how can they create or engineer environments that enable a diverse student population to connect and engage with each other, to express themselves and have fun, in spaces beyond the narrow confines of alcohol-infused environments.
Strengths and limitations
This study focuses on two types of institution taking part in the REACT programme and therefore does not claim to be representative of all participating institutions. Moreover, given the qualitative nature of the study, it does not purport to represent the perspectives of the entire college student population in this country. Also, the authors acknowledge that the decision to use focus groups may yield different results to a study utilising individual interviews, although use of a researcher experienced in group facilitation sought to ensure that the focus groups were as inclusive as possible. A particular strength of the study is its inclusion of different categories of student – namely, younger undergraduates, mature students, international students and those who are members of clubs and societies. In this regard, the study has sought to capture a range of perspectives, acknowledging that the student population is not necessarily a homogenous group.
Implications of the research
The findings of this research highlight a number of important considerations for the REACT programme and other alcohol prevention initiatives of this kind. Firstly, given the high density of alcohol outlets and activities off campus reported by students, the study recommends a greater focus on alcohol prevention efforts in the surrounding community and not just in the college setting for such programmes. Mapping of licensed premises in the area, an optional action point of REACT, may constitute an important measure, for example, not only in gathering important information but also for lobbying local authorities on the need to reduce the high density of alcohol outlets and to help mitigate potential displacement effects among college students. The clear emphasis on the desire and need for more alcohol-free spaces and activities found in this study also signals the need for a more proactive rather than reactive approach to alcohol policy in the college sector. We note that the provision of alcohol-free accommodation and spaces is a further optional action point of REACT and recommend that this be developed as a core part of such programmes going forward. Moreover, further research on the impact of such measures would be worthwhile.
The growing diversity of the student population, both in terms of demographics and drinking behaviours, is another notable finding of this study and we recommend that student representation, including representation on the REACT steering committee, should give due consideration to the broad and varied nature of the student voice, providing greater opportunities for this increasingly diverse population to inform programmes and policies directed at them. This could include greater opportunities for participatory and co-design research approaches, where students act as partners rather than participants in research conducted to inform programme design.
Footnotes
Acknowledgements
The authors would like to thank Professor Ivan J. Perry, Dr Michael Byrne and Dr Órla O’Donovan, University College Cork, for their guidance during this research.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research has been co-funded by the Health Service Executive (HSE) and Tomar Trust.
