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‘If I don’t look good, it just doesn’t go up’: A qualitative study of young women’s drinking cultures and practices on Social Network Sites
Int J Drug Policy. 2016 Dec;38:50-62, 2016.
Abstract BACKGROUND: Young women in the UK often partake in a culture of intoxication in the pursuit of pleasure and friendship fun. Experiences of intoxication and drinking spaces remain highly gendered, and relative to men, women continue to find their behaviours in drinking spaces more constrained and scrutinised. Simultaneously, young women now express themselves via Social Network Sites (SNS), where they display drinking experiences and where they perform, negotiate and display contemporary femininities. METHODS: The research explored young women's experiences of drinking and intoxication, the use of SNS in their drinking cultures and the display of drinking practices on SNS through group interviews (n=12) with women (n=37) aged 16-21 from one city in the North-West of England, UK. RESULTS: The practice of uploading drinking photographs to SNS played an important role in displaying young women's popularity, enhancing friendship fun and belonging, and in positioning the hyper-sexual feminine look as the norm in drinking spaces. Both intoxication and the hyper-sexual and feminine look challenged traditional notions of respectable femininity, while the highly groomed feminine look itself was threatened by drunkenness. As such, young women invested much work and effort in self-surveillance and in managing the display of their drinking behaviours on SNS. CONCLUSION: The dilemmas in contemporary femininity created by the juxtaposition of hyper-sexual femininity and the culture of intoxication are reproduced on SNS. Controlling and restricting certain content on SNS with the aim of achieving the 'right' feminine self-presentation resulted in a narrowly set of body oriented and behavioural feminine attributes being presented as the norm, and an overly positive online representation of young women's drinking experiences.
An exploration of alcohol advertising on social networking sites: an analysis of content, interactions and young people’s perspectives
Addiction Research & Theory, 2016.
Abstract: Young people increasingly communicate and interact via social digital media such as Social Network Sites (SNS), where they discuss and display alcohol-related content. SNS have also become an important aspect of the alcohol industry’s multi-platform marketing strategies, which may contribute to the creation of intoxigenic digital spaces in which young people learn about alcohol. This paper presents findings of a content analysis of the extent, nature, and user interaction with SNS-based alcohol marketing for brands popular among young people in the UK. It provides a systematic analysis of both official and user generated marketing content on brand Facebook and Twitter profiles, and user interaction with such content. Findings from peer group interviews (N = 14) also present young people’s (N = 70) perspectives and experiences regarding alcohol marketing on SNS. New SNS engagement marketing strategies extended existing multi-platform brand marketing. Young people interacted with such strategies as part of their identity-making practices, yet through a discourse of immaturity distanced themselves from certain brands, online marketing practices and the idea that their own actions were influenced by marketing. Local night life economy marketing appeared more meaningful and relevant to young people and led to further interaction with brand marketing. Implications of the findings are discussed in relation to the influence of alcohol marketing on young people, and the implications for current regulatory frameworks.
Adolescents’ reflections on school-based alcohol education in the United Kingdom: education as usual compared with a structured harm reduction intervention
Séamus Harvey, Dr Michael McKay, Professor Harry Sumnall
Journal of Substance Use Volume 21, 2016 - Issue 6, 2016.
Abstract: Alcohol consumption by adolescents in the United Kingdom (UK) remains high. School-based interventions are expected to play a key role in preventing adolescent alcohol consumption. A series of focus groups were conducted with pupils who received alcohol education as usual and pupils who received a Northern Ireland adaptation of the School Health and Alcohol Harm Reduction Project (SHAHRP), a universal alcohol education program designed to reduce the harms experienced by young drinkers. This study sought to compare and contrast the participants’ engagement with and enjoyment of the different alcohol education that they had received. Focus groups were completed with 129 pupils in 16 schools in Northern Ireland and Scotland. Alcohol education as usual was viewed negatively and was regarded as unstructured, boring, repetitive, and unrealistic. In contrast, the adaptation of SHAHRP was viewed positively and was regarded as enjoyable and worthwhile, and engaging and relevant to the participants’ experiences of alcohol use. These findings suggest that one reason why alcohol education as usual may not be successful in preventing adolescent drinking and protecting adolescents from negative outcomes may be due to its failure to engage participants. Higher acceptability by pupils means that the adaptation of SHAHRP may be one viable alternative.
NOFAS-UK Research Publication, Issue 13, June, 2015.
Holidays, celebrations, and commiserations: measuring drinking during feasting and fasting to improve national and individual estimates of alcohol consumption
BMC Medicine, 13:113, 2015.
Abstract: Background: Accurate measures of alcohol consumption are critical in assessing health harms caused by alcohol. In many countries, there are large discrepancies between survey-based measures of consumption and those based on alcohol sales. In England, surveys measuring typical alcohol consumption account for only around 60% of alcohol sold. Here, using a national survey, we measure both typical drinking and atypical/special occasion drinking (i.e., feasting and fasting) in order to develop more complete measures of alcohol consumption. Methods: A national random probability telephone survey was implemented (May 2013 to April 2014). Inclusion criteria were resident in England and aged 16 years or over. Respondents (n = 6,085) provided information on typical drinking (amounts per day, drinking frequency) and changes in consumption associated with routine atypical days (e.g., Friday nights) and special dinking periods (e.g., holidays) and events (e.g., weddings). Generalized linear modelling was used to identify additional alcohol consumption associated with atypical/special occasion drinking by age, sex, and typical drinking level. Results: Accounting for atypical/special occasion drinking added more than 120 million UK units of alcohol/week (~12 million bottles of wine) to population alcohol consumption in England. The greatest impact was seen among 25- to 34-year-olds with the highest typical consumption, where atypical/special occasions added approximately 18 units/week (144 g) for both sexes. Those reporting the lowest typical consumption (≤1 unit/week) showed large relative increases in consumption (209.3%) with most drinking associated with special occasions. In some demographics, adjusting for special occasions resulted in overall reductions in annual consumption (e.g., females, 65 to 74 years in the highest typical drinking category). Conclusions: Typical drinking alone can be a poor proxy for actual alcohol consumption. Accounting for atypical/special occasion drinking fills 41.6% of the gap between surveyed consumption and national sales in England. These additional units are inevitably linked to increases in lifetime risk of alcohol-related disease and injury, particularly as special occasions often constitute heavy drinking episodes. Better population measures of celebratory, festival, and holiday drinking are required in national surveys in order to adequately measure both alcohol consumption and the health harms associated with special occasion drinking.
Relationship between alcohol-attributable disease and socioeconomic status, and the role of alcohol consumption in this relationship: a systematic review and meta-analysis
BMC Public Health, 15:400, 2015.
Abstract: Background: Studies show that alcohol consumption appears to have a disproportionate impact on people of low socioeconomic status. Further exploration of the relationship between alcohol consumption, socioeconomic status and the development of chronic alcohol-attributable diseases is therefore important to inform the development of effective public health programmes. Methods: We used systematic review methodology to identify published studies of the association between socioeconomic factors and mortality and morbidity for alcohol-attributable conditions. To attempt to quantify differences in the impact of alcohol consumption for each condition, stratified by SES, we (i) investigated the relationship between SES and risk of mortality or morbidity for each alcohol-attributable condition, and (ii) where, feasible explored alcohol consumption as a mediating or interacting variable in this relationship. Results: We identified differing relationships between a range of alcohol-attributable conditions and socioeconomic indicators. Pooled analyses showed that low, relative to high socioeconomic status, was associated with an increased risk of head and neck cancer and stroke, and in individual studies, with hypertension and liver disease. Conversely, risk of female breast cancer tended to be associated with higher socioeconomic status. These findings were attenuated but held when adjusted for a number of known risk factors and other potential confounding factors. A key finding was the lack of studies that have explored the interaction between alcohol-attributable disease, socioeconomic status and alcohol use. Conclusions: Despite some limitations to our review, we have described relationships between socioeconomic status and a range of alcohol-attributable conditions, and explored the mediating and interacting effects of alcohol consumption where feasible. However, further research is needed to better characterise the relationship between socioeconomic status alcohol consumption and alcohol-attributable disease risk so as to gain a greater understanding of the mechanisms and pathways that influence the differential risk in harm between people of low and high socioeconomic status.
Incidents of harm in European drinking environments and relationships with venue and customer characteristics
Dr Zara Quigg, Professor Karen Hughes, Professor Mark Bellis, Ninette van Hasselt, Amador Calafat, Matej Kosir, Mariangels Duch, Montse Juan, Lotte Voorham, Ferry Goossens
The International Journal Of Alcohol And Drug Research, August 2014.
Abstract: Aim: Research shows there are associations between bar environments and alcohol-related harms. However, few European studies have examined such links. Our study investigates the type of harms experienced by patrons in European bars, and their relationships with individual, social and environmental factors. Design: Unobtrusive one-hour observational visits. Characteristics of the bar environment, staff and patrons, and harms observed were recorded on structured schedules. Setting: Bars in four cities in the Netherlands, Slovenia, Spain and the United Kingdom (U.K.). Participants: 238 observations across 60 bars. Measures: Analyses utilized chi-squared, analyses of variance and logistic regression. Findings: 114 incidents of harm were observed; in one-fifth of visits, at least one incident was recorded. People falling over, arguing or being so severely intoxicated that they required assistance to walk were the most common incidents observed. Bivariate analyses showed associations between a range of staffing, customer and environmental characteristics, and incidents of harm. Controlling for city and venue, only a permissive environment remained significant in multivariate analyses. Conclusions: Harms occurring in nightlife venues are typically minor. However, such incidents have the potential to escalate into more serious harms; thus, prevention is crucial. Prevention should focus on improving venue management practice and on the behavioral standards expected of customers.
The differential impact of a classroom-based, alcohol harm reduction intervention, on adolescents with different alcohol use experiences: A multi-level growth modelling analysis
Dr Michael McKay, Professor Harry Sumnall, Nyanda McBride, Séamus Harvey
Journal of Adolescence, Volume 37, Issue 7, Pages 1057–1067, October 2014.
Abstract: While evidence has accumulated suggesting that prevention initiatives may have a limited impact on alcohol use behaviour, reviews suggest that interventions with most potential for behavioural change are interactive and developmental in design. The School Health and Alcohol Harm Reduction Project (SHAHRP) is an example of such an intervention. Researchers are increasingly attempting to understand the differential effects of programmes in population subgroups. The present study is a secondary analysis of data from a non-randomised trial of SHAHRP, a classroom-based alcohol education intervention, involving school children (aged 13–16 years old) in the United Kingdom. Results showed that there were significant positive changes in knowledge about and attitudes towards alcohol in baseline abstainers, supervised drinkers and unsupervised drinkers. Significant positive behavioural effects in terms of amounts consumed, frequency of drinking and self-reported alcohol related harms, were observed almost exclusively among baseline unsupervised drinkers. These behavioural effects support those previously observed in Australia and suggest that the intervention is a viable health promotion tool in the UK.
Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in the European Region
Professor Mark Bellis, Professor Karen Hughes, Nicola Leckenby, Lisa Jones, Adriana Baban, Margarita Kachaeva, Robertas Povilaitis, Iveta Pudule, Gentiana Qirjako, Betul Ulukol, Marija Raleva, Natasa Terzic
Bulletin of the World Health Organization, Online first format, 2014.
Abstract: Objective To evaluate the association between adverse childhood experiences – e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration – and the health of young adults in the eastern European Region. Methods: Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10’696 respondents – 59.7% female – aged 18–25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide. Findings: Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval (CI): 1.32–2.15) – for physical inactivity – to 48.53 (95% CI: 31.98–76.65) – for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population. Conclusion: Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in the eastern European Region.
Does legislation to prevent alcohol sales to drunk individuals work? Measuring the propensity for night-time sales to drunks in a UK city
Professor Karen Hughes, Professor Mark Bellis, Nicola Leckenby, Dr Zara Quigg, Katie Hardcastle, Olivia Sharples, David J Llewellyn
J Epidemiol Community Health, doi:10.1136/jech-2013-203287, 2014.
Abstract: Background: By measuring alcohol retailers’ propensity to illegally sell alcohol to young people who appear highly intoxicated, we examine whether UK legislation is effective at preventing health harms resulting from drunk individuals continuing to access alcohol. Methods: 73 randomly selected pubs, bars and nightclubs in a city in North West England were subjected to an alcohol purchase test by pseudo-drunk actors. Observers recorded venue characteristics to identify poorly managed and problematic (PMP) bars. Results: 83.6% of purchase attempts resulted in a sale of alcohol to a pseudo-intoxicated actor. Alcohol sales increased with the number of PMP markers bars had, yet even in those with no markers, 66.7% of purchase attempts resulted in a sale. Bar servers often recognised signs of drunkenness in actors, but still served them. In 18% of alcohol sales, servers attempted to up-sell by suggesting actors purchase double rather than single vodkas. Conclusions: UK law preventing sales of alcohol to drunks is routinely broken in nightlife environments, yet prosecutions are rare. Nightlife drunkenness places enormous burdens on health and health services. Preventing alcohol sales to drunks should be a public health priority, while policy failures on issues, such as alcohol pricing, are revisited.