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Most people are aware of the dangerous consequences of excessive drinking. However, most people think about excessive drinking like they do about gun ownership: that in a variety of contexts, it’s perfectly safe and normal. Several studies—including our own research—show that most people believe that the acceptability of excessive drinking is determined by the context in which one drinks.1 2 3

If we apply this belief to gun ownership, it makes perfect sense. Where and how you use your gun fully influences whether the use of your gun might be considered "excessive." However, when applied to excessive drinking, the framework begins to fall apart. Most research shows that "situation" or "place" plays a substantial role in shaping individual’s perceptions of whether a drinking behavior should be considered excessive. For instance, most people note parties, vacation spots, and college as places where excessive drinking is normal and expected.

The problem with a place or situation significantly impacting the social acceptance of excessive drinking is that, no matter the situation, consuming a lot of alcohol puts people at risk for serious health issues even in the short term. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), short-term excessive drinking can cause the following health problems:4

  • Heart problems: Both binge drinking and long-term heavy drinking can cause a variety of heart problems including dizziness, arrhythmias, hypertension, blood clots, and strokes. Recent studies show that people who binge drink are about 56 percent more likely than people who never binge drink to suffer an ischemic stroke.
  • Liver problems: Heavy drinking—even for just a few days at a time—can cause fat to build up in the liver. This condition, called steatosis, or fatty liver, is the earliest stage of alcoholic liver disease and the most common alcohol-induced liver disorder.
  • Safety problems: Binge drinking or short-term heavy drinking greatly increases one’s risk of injuries (such as motor vehicle crashes, falls, drownings, and burns) and violence (including homicide, suicide, sexual assault, and intimate partner violence).

As a health researcher and educator, I know from experience that not only do most people think it is fine to drink excessively in certain contexts, but they have been somewhat oversaturated by drunk driving prevention campaigns that attempt to shame and guilt them into better behavior.5 People are a little bored with the idea of excessive drinking or even alcoholism being a problem. I mean, goodness, we have an opioid epidemic, an obesity epidemic, and the potential for a second generation of smokers with the rise of vaping and other electronic nicotine delivery systems. In recent years, there have been Ebola and Zika virus outbreaks, not to mention terrible increases in mortality due to gun violence and various forms of terrorism. When stacked up against the intensity of all these other modern maladies, why are public health professionals still so concerned about excessive drinking?

Well, for one, alcohol is linked to 88,000 deaths a year.6 That’s more than two-and-a-half times the number of deaths caused by opioid overdose 7 and, according to some sources, more than all drug overdose deaths combined. 8 Excessive drinking also increases your risk for many different types of problems that it can even be hard for a public health nerd like me to keep up with the variety of damages it can cause: cancer, dementia, infertility, poor mental health.

At Fors Marsh Group, we believe that in order to engage consumers on topics related to their health, we have to develop health messages that communicate information that consumers are already seeking. Our research shows that, in spite of all the evidence of negative health outcomes caused by excessive drinking, health and risk messaging are not the primary influencers of drinking behavior. So where do we turn? How might we begin to transition people from trying to find the best "hangover cure" to simply moderating their drinking behavior?

We, in the health communication sphere, need to start targeting the perceived social appropriateness of excessive drinking. Currently, excessive drinking is considered to be inappropriate in some situations, but not others. We need to develop messaging that questions and challenges the social normalization of excessive drinking, especially in celebratory and stress-reducing contexts. Ultimately, changing public perceptions around the social acceptability of excessive drinking will require a powerful counter-narrative to current drinking culture: embracing moderate and balanced lifestyle choices.

1 Real, K.,& Rimal, R. N. (2007). Friends talk to friends about drinking: exploring the role of peer communication in the theory of normative social behavior. Health Communication, 22(2), 169–180. Doi:10.1080/10410230701454254

2 Segrist, D. J., & Pettibone, J. C. (2009). Where’s the bar? Perceptions of heavy and problem drinking about college students. Journal of Alcohol and Drug Education, 53(1), 35–53.

3 Beck, K. H., & Treiman, K. A. (1996). The relationship of social context of drinking, perceived social norms, and parental influence to various drinking patterns of adolescents. Addictive Behaviors, 21(5), 633–644. doi:10.1016/0306-4603(95)00087-9


About the author

Claire Constance

Claire Constance

Claire Constance is a public health researcher with over five years of experience conducting mixed-methods research for government and private sector clients. Claire has conducted research both domestically and internationally on sensitive topics related to health communication, organizational branding, and campaign development. In her time at FMG, Claire has managed and supported studies for government clients such as CBP, U.S. Coast Guard, DOD, and FDA. As a RIVA-trained focus group moderator, Claire has used her qualitative expertise to inform the design and execution of interviews, focus groups, and surveys for the development and evaluation of educational materials, campaigns, policies, and brands. Before working at FMG, Claire was a health policy fellow at the International Organization of Migration where she provided research and consulting expertise on migrant health policy. During her tenure at UVA, Claire served as the Student Liaison of UVA’s Center for Global Health where she provided strategy and guidance on public health education and programming.

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