Alcohol and Culture Change: Current Challenges and Conundrums

1. Alcohol and Culture Change: Current Challenges and Conundrums Ann M RocheDirector, National Centre for Education and Training on Addiction, NCETA Flinders Universityann.roche@flinders.edu.au Thinking Drinking 3, Brisbane 5-7 August 2009

2. What is Culture? • Culture refers to the cumulative deposit of knowledge, experience, beliefs,values, attitudes, meanings, hierarchies, religion, notions of time, roles, spatial relations, concepts of the universe, and material objects and possessions. • Culture is communication, communication is culture. • Culture is symbolic communication. Some of its symbols include a group's skills, knowledge, attitudes, values, and motives. The meanings of the symbols are learned and deliberately perpetuated in a society through its institutions. • Culture consists of patterns, explicit and implicit, of and for behaviour acquired and transmitted by symbols, the essential core of culture consists of traditional ideas and especially their attached values; culture systems may, on the one hand, be considered as products of action, on the other hand, as conditioning influences upon further action. • Culture is a collective programming of the mind that distinguishes the members of one group or category of people from another.

3. Where Does Alcohol Sit?Dominant social relations construct the object and shape the discourse. Hence alcohol has been variously seen as: a necessity of life, a poisonous substance, a hazardous drug, a social lubricant or a key element of the economy (Foucault, 1995).

4. Alcohol’s changing historical perspective: 1830’s issue of free trade Mid-Victorian era issue of individual morality +1880’s increasingly a question of social reform During WWI issue of national efficiency inter-war years issue of leisure, & town planning Post WWII re-emerged as a medical issue Then emerged as a public disorder issue with concern over anti-social behaviour by young people Defined also as a part of the leisure industry and tourism which frames the issue in terms of leisure and tourism rather than health or public order Also a central part of global corporatisation and contemporary libertarian world view (e.g. David Korten ‘When Corporations Rule the World’)

5. Alcohol issues are complex – involve leisure, food, town planning, free markets, public order …. • Both culture change and policy shift can be achieved if both the venue and discourse allow new alliances to flourish (Greenaway, 2008) • Western culture possess two defining features: materialism and individualism • danger of simplifying the politics of alcohol by neglecting the importance of the framing of and discourse on issues • The anti-smoking analogy is of limited value

6. Evidence Based Practice and Policy • Research and evidence is the cornerstone of culture change • While EBP is of fundamental importance, not all initiatives need to be evidence based ! • [note introduction of needle availability to counteract spread of HIV AIDS – NOT an evidence based strategy, but proved to be highly successful]. • Must also engage in innovative work to be able to move forward • Trust our intuition, judgement and aspirations

7. Tipping Point(Gladwell, 2001) ‘punctuated equilibrium’ (Baumgartner and Jones, 1993)

8. What’s Changed? • Many important social changes in families, lifestyles & women’s roles • Concept of ‘Youth’ • Concept of ‘Culture’ • Eternal pursuit of ‘Youthfulness’ • Commodification of leisure • Views about work/life balance • Drinking patterns (incl. what we drink, how we drink) • Implications for ‘Low Risk’ drinking and prevention

9. YP stay in education longer • Sexual intercourse experienced earlier and earlier ages (42% years 10-12 had had sexual intercourse (2002) • More unsupervised time • Different experience of ‘family’ : 1 in 6 families in 2006 were single-parent families vs 1 in 17 in 1970’s • Get married later (21/23 yrs,1970 – 28/30 yrs, 2005) • 3 M’s deferred (Marriage, Mortgage, Maternity) • Live at home longer (KIPPERS) • Have more expendable income • Different views about work/life balance • Leisure and recreation a greater priority and we live in an increasingly individualised and socially disconnected world

10. NCETA Research Cultural focus : – examines role of social, economic & political influences

11. New NCETA Report Qualitative Research 14-24 year olds (20 FG, 90 interviews, 12 field observations) Key themes: • Sociality and imperative to belong, demonstrate commitment x risk taking • Negotiating ever changing social interactions – issue of confidence • Lack of viable non-drinking identities [and real world] options • Duty of care [esp. among females] • Gender issues and the invisible male in ‘regrettable’ incidents

12. Individual freedom vs controlExcess vs ConstraintEconomic neoliberalism and globalizationPleasure vs pathologyPursuit of happiness vs good in a consumer society

13. Leisure Lifestyle • Consumer culture characterised by recreation and indulgence • Greater emphasis placed on work-life balance

14. Leisure Lifestyle in Consumer Society • Generational changes

15. Leisure and Lifestyle • consumption is central to the leisure experience • leisure is central to one’s image • aspirational, risk-taking, status-defining, and image-enhancing leisure time pursuits (Measham, 2004)

16. Leisure Lifestyle Consumption of alcohol: • Popular leisure activity • Important element of socialisation • Identity within and distinction between friendship groups • Excessive consumption • Has become normative

17. The Absence of Society(Zygmund Bauman, 2008) Describes current driving force of behaviour as no longer the desire to: “…keep up with the Joneses, but the infuriatingly nebulous idea of catching up with supermodels, premier league footballers and top-ten singers.” Some argue that materialism drives us to consume alcohol (and drugs) because materialism cannot fulfill our search for meaning.

18. Social Contagion Theory • (see O.J. Skog)

19. Pleasure • Seems axiomatic that pleasure is one of the main motivators for alcohol use. But rarely mentioned or reflected in our policies. Our policies suggest that alcohol use only ever emerges from or leads to misery, ill health, and social dysfunction. • Speaking the unspeakable. Alcohol use and leisure activities with which it is associated are inherently about pleasure. • Much neglected area of public health (since time of Plato) • Too hard to deal with? • Ignore, disparage, relegate to the inconsequential at our peril.

20. Field Observation [field note excerpt #3] Observer at Good Vibrations Music Festival: “Entering the grounds of the music festival was like entering another world for the day…there is a sense that social rules and ways of relating to each other were quite different from the outside world, allowing people to engage with each other with a sense of freedom, free from the formality of being among strangers in the “real world”. There was a sense of community… freedom from normal social conventions, like they were all in it together.”

21. Market Forces • Market forces - global • Advertising/Marketing influence young people’s decisions about drinking: • When to drink (initiation) • What to drink • How much to drink • Where to drink • Who to drink with • Advertising/Marketing – part of cultural context

22. Promotion • Sponsorship

23. Placement • Branded promotional material • Point-of-Sale • Position • Films, TV, music

24. Price • “Happy Hour” • “Pre-loading”

25. Generational change = new ways of drinking • Drinking style of young people differs to adult counterparts e.g., “determined drunkenness”, “vertical drinking”

26. Protective Factors Location of first drink – children who first use alcohol in a home environment and learn about its effects from parents are less likely to misuse alcohol than those who begin drinking outside the home with peers Delaying time of first drink Having adults who have good relationships with appropriate levels of control and support Controlled alcohol use is not predictive of later problems Religious affiliation, esp attendance at religious services Informed and supportive parental guidance and delay in age of initiation Positive Consequences Some YP benefit from increased confidence when communicating with the opposite sex Alcohol can increase YP’s feelings of sociability Drinking alcohol as a means of celebrating and on special occasions may be positive for YP Impact of Alcohol Consumption on Young People(Newbury-Birch et al., 2009)

27. Current Epidemiological Evidence indicates… (Newbury-Birch et al., 2009) • Delaying the onset of regular drinking, by changing the attitudes of 11-15 year olds, and their parents, about alcohol. • Reducing the harm to young people who have already started to drink • Creating a culture in which YP feel they can have fun without needing to drink. (inc. in England’s Alcohol HR Strategy, 2007)

28. Reported age of first full serve of alcohol, by age cohort (2004 NDSHS)

29. The Shift to Spirits Changes in types of alcohol consumed by risky drinkersaged 15 to 17 from 2001 to 2004 (data from 2000-2004 NAC)

30. Harm from Drinking Alcohol • Harm per volume for drinkers drinking less than three standard drinks per session

31. Complex Problems Child Awareness (child protection) Domestic Violence Sexual Assualt

32. The Harm Reduction Continuum of Acceptability tobacco alcohol Illicits HIV/AIDS

33. Opportunities for Socio-Cultural Change • Workplace • Schools (school to work transition) • Parents • Sport • Provision of legitimate and valued non-drinking leisure options • Redefining the Australian national identity

34. 1. Workplace Changing workplace cultures (Pidd and Roche, 2008)

35. 1. Workers’ Alcohol use (2004 NDSHS) % of drinkers aged 14 years and over, by employment status

36. Workers’ alcohol use by age % drinking weekly (or more often) at risky & hi-risk levels

37. Proportion of workforce drinking weekly at short-term risky & hi-risk levels, by age & gender

38. Transition from School to Work • Some workplaces more conducive to the development of risky patterns of drinking than others e.g. hospitality industry • Workplace ‘culture’ a pivotal factor

39. Workers’ alcohol use by industry % drinking weekly (or more often) at risky & hi-risk levels

40. New NCETA Reports

41. 2. Schools 1. Connectedness 2. Social norming 3. Media analysis skill 4. Social skills development 5. Gender issues (incl. sexual ‘assault’)

42. Social Norms Interventionsto reduce alcohol misuse in university or college students New Cochrane Collaboration review Moreira, Smith and Foxcroft. 2009 Cochrane review

43. Sexualisation of Young Women/Girls New Australian report of High levels of sexual assault experienced by young females – attributed to coercion and alcohol

44. 3. Parenting • Empower • Support • Upskill

45. Socio-cultural drinking traditions and Parenting • Leisure realm = rich forum for enculturation • Normative behaviours around drinking are assumed & expressed Clipsal 500, Feb ‘08

46. Number of one-parent families in Australia (data from ABS, 1997, 2006 and 2007) 1 in 6 families in 2006 were single-parent families vs 1 in 17 in 1970’s

47. 4. Sport

48. Reframing Alcohol and Sport

49. 5. Provision of legitimate and valued non-drinking leisure options

50. 6. Redefine the Australian national identity