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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

4https://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.pdf
5https://insight.kellogg.northwestern.edu/article/doanti-drinkingads_work
6https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
7https://www.cdc.gov/drugoverdose/index.html
8https://www.vox.com/policy-and-politics/2017/8/10/16124938/study-alcoholism-addiction-epidemic

About the author

Claire Constance

Claire Constance

Claire Constance has more than four years of training in mixed-methods public health research. Claire has developed early childhood development curriculum for nurses in South Africa, conducted legislative needs assessments for European governments struggling to incorporate migrants and refugees into their health care systems, and designed surveys to measure perceptions of access to health care for homeless persons in Charlottesville, VA. As a researcher for Fors Marsh Group, Claire supports health-focused research across the entire Communication Research team portfolio.

Claire has presented her research at the Consortium of Universities for Global Health Conference and the International Conference of the School of Health Sciences at the University of Venda, South Africa. For her research over the past few years, Claire has received the following University of Virginia affiliated awards: the Raven Society Research Fellowship, the Center for Global Inquiry and Innovation Grant, the Center for Global Health Scholar Award, the Jefferson Public Citizens Award, and the Jefferson Trust Grant.

Before joining Fors Marsh Group, Claire managed the student branch of the University of Virginia’s Center for Global Health and directed the Health Outreach and Practical Education (HOPE) project, a student initiative to conduct diabetes screening and education events in Charlottesville, VA. Claire holds a Master of Public Health and a B.A. in Global Public Health from the University of Virginia.

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