Alcohol and Tobacco Consumption
The final item of business is a members' business debate on motion S3M-668, in the name of Bill Wilson, on perceived norms of alcohol and tobacco consumption: pilot studies in Scottish educational institutions. The debate will be concluded without any question being put.
Motion debated,
That the Parliament notes the recent survey on student alcohol consumption carried out by McAlaney and McMahon in the University of Paisley and detailed in Journal of Studies on Alcohol and Drugs (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?linkbar=plain&db=journals&term=0096-882X (2007; 68(3):385 – 392); notes that it replicates work in the United States of America that has demonstrated that most people overestimate the alcohol and tobacco intake of their peers and that this misperception of the norm leads to increased consumption; notes the authors' statement that this raises the possibility of applying social norms interventions, as demonstrated to be effective in the USA, to the United Kingdom; further notes that pilot schemes along these lines are being undertaken in several schools in the Croydon area of England, and considers that the practicality of initiating such schemes in Scottish educational institutions should be investigated.
Recently, The Herald published a lengthy report on children under eight years old who commit crimes. The youngest alleged offender was two years old. A headline in the Edinburgh Evening News screamed, "One in 70 revellers goes out armed with knife". In an article that condemned drunkenness and alcohol abuse among youth in England, The Observer asked, "Who let the yobs out?" There is a wide perception of moral decay. Questions have been asked:
"What is happening to our young people? They disrespect their elders, they disobey their parents. They ignore the law. They riot in the streets, inflamed with wild notions. Their morals are decaying. What is to become of them?"
In the face of such evidence, how can anyone doubt that our society is irretrievably doomed? "We're a' doomed"—what other perception could be accurate?
Perhaps that is the point; I am talking about a perception. We are told that the youth of today are violent, degenerate and drunken. According to MORI research, 71 per cent of news stories that refer to youth are negative. There is an alternative view of Scotland's youth. If one in 70 youthful revellers carries a knife, 98.5 per cent do not carry knives. Of course the 1.5 per cent are a problem, but our streets are hardly awash with blood and weapons. In the article entitled, "Who let the yobs out?" there was a small flaw. The journalist did not know the levels of drunkenness among English youth but had observed youthful drunks on the street and extrapolated, to draw an extremely negative conclusion. As for the quotation about the behaviour of our young people, it is attributed to Plato and is approximately 1,600 years old—give or take a year or two. If Plato had been right, society should by now be made up of the most extraordinary collection of degenerates—perhaps I should move on.
Perceptions matter. They shape attitudes, responses and—more important—misperceptions. Misperceptions are created and perpetuated in various ways, for example through ill-informed and misleading news articles and people's natural tendency to brag: "What you drank was nothing. I had 10 pints last night!"—I did not, by the way; this is not a confessional speech.
Misperceptions also arise because we tend to remember the unusual. If someone is a little the worse for wear one evening, that is what people will talk about. The 500 other occasions on which the person was stone cold sober generate no comment or excitement whatever.
Nobody disputes that our behaviour is influenced by our peer group, but it is clear that most people have a false idea of how their peers behave. When we consider potentially harmful behaviour, we need to ask two simple questions. How do we really behave? How do we perceive our peers to behave? Those questions lie at the heart of social norming.
There are now more than 25 studies of student drinking patterns and students' perceptions of those patterns. The results are consistent—students overestimate peer risk taking. The results of a study by the University of Paisley are typical. All undergraduate students in the university were offered the chance to take part in a web-based survey, and some 500 responses were returned. The majority of respondents overestimated peer alcohol consumption. Younger respondents were more likely to overestimate. The majority of students perceived themselves to be drinking less frequently than the average student. Approximately 50 per cent of students stated that they did not become drunk in a normal month yet, importantly, only 4 per cent of students believed that to be the normal frequency of drunkenness.
The important messages in the study are that young people are more likely to overestimate risk-taking behaviour; that when individuals feel that they are under peer pressure, that pressure is to increase their drinking; and that when individuals fit the peer group patterns of behaviour, the majority still perceive themselves not to do so. An obvious question follows—if individuals are made aware of the actual peer group behaviour patterns, will that reduce risk-taking behaviour. The answer appears to be yes. There is strong evidence to show that the social norms approach, when it is not accompanied by scare stories, hectoring or denigration, can reduce alcohol abuse. It can encourage safer, more considered attitudes to drink.
Several programmes have now used the social norms approach to reduce risk-taking behaviour. One example is an attempt to reduce alcohol consumption among college athletes in New York. The programme ran for three years and was based on an annual survey of student behaviour. The surveys found that 66 per cent of student athletes drank alcohol less than once a week or not at all, 88 per cent believed that one should never drink to a level that affects one's responsibilities, and 71 per cent did not use alcohol to relieve academic pressure. The project then disseminated the results and other, similar, findings. A wide range of approaches, such as messages in newspapers, email messages and interactive CDs, were used. Importantly, there was no use of scare tactics or condemnation. The involvement of student athletes as so-called peer educators was also important. The results were that frequent personal use of alcohol, high-quantity consumption of alcohol and the negative consequences of alcohol consumption all declined by 30 per cent or more.
The University of Paisley, in conjunction with Youth Media, has now embarked on a United Kingdom-wide social norms project that is one of the largest in the world. The initial survey concludes this week. It is expected that there will be 20,000 responses from universities and colleges, including more than 2,000 from Scotland. Results that relate to students' smoking, drinking, sexual activity and exercise will be reported in January. The social norms data will then be fed back to the students over the next three months. A follow-up survey in April will assess the impact. If it proves successful, the duration and scope will be extended.
In Croydon in south London, the social norms approach is being applied to 16 schools to reduce bullying. It is hoped that the programme will be expanded to tackle a wider range of issues. I believe that we should pilot the social norms approach in Scottish schools. Why target schools? We can look at smoking to answer that. Consider just three facts. According to a BBC report, 80 per cent of smokers take up the habit as teenagers. There is clear evidence from a recent Cancer Research study in England that young people significantly overestimate how many people smoke. In Scotland, 85 per cent of 15-year-olds do not smoke. The social norm among that group is non-smoking. In other words, among young people, there is a large gap between the perception of smoking and the reality. If we can correct that misperception and make it easier for teenagers to say no to smoking, they are more likely to remain non-smokers.
The potential for a social norms approach in schools is clear. School intakes can be followed and compared statistically over several years. Social norms programmes offer an effective way to tackle risk-taking behaviour before it takes root and have great potential for being embedded in the school curriculum. They are more likely to be effective if the target audience is involved—that is what would make them ideal: school pupils could help design the surveys, analyse the data and present and publicise the results.
I urge the Scottish Government to examine the use of the social norms approach to tackle risk-taking behaviour in our schools. The time is right to pilot the approach in Scotland. It is based not on wishful thinking, but on a clear and rational model that seeks to include our young people in finding a solution rather than impose a solution on them. Above all, it is an approach that rejects the negative and emphasises the positive. Most of Scotland's youth does not smoke, does not get drunk, and does not
"riot in the streets, inflamed with wild notions."
Mr Wilson makes a cogent argument that arises from an interesting presentation that was given to Scotland's Futures Forum.
In drugs, we have moved from the just say no programme to the know the score campaign. In relation to tobacco, we have succeeded in changing attitudes. The number of people in the population who smoke has reduced substantially. The Scottish schools adolescent lifestyle and substance use survey, which has been carried out every two years, with only one year's break, since 1982, shows that the number of boys who smoke has dropped from 30 per cent to 12 per cent. The number of girls who smoke has reduced slightly but, regrettably, it is still substantially higher than the figure for boys.
The 2006 SALSUS figures show that there has been a substantial reduction in the number of 13 to 15-year-olds who start to drink. The number who drink excessively or heavily has also reduced, alternative there is concern about binge drinking, again particularly among girls.
We do not publicise those results enough. When they were published, there was nothing in the press to say that Scottish youth is moving in the right direction and should be praised for that. Bill Wilson's motion says more than that. We need to define programmes that build on the work that has been done to provide knowledge in every school. We need to ensure, first, that information is guaranteed to be provided, that the information is much more powerful, and that young people come back to us and say that the education that they get is meaningful and useful. Secondly, as Bill Wilson pointed out, we need young people to participate in driving forward a programme that emphasises that X per cent do not smoke and that more than half of those who smoke want to give up.
The significant minority of young people who drink know about getting into trouble with the police, getting involved in arguments and fights, being taken home by the police and so on—there is a list of such things in the SALSUS report. We need to encourage young people to understand that that is not normal behaviour. We need to do more; we need to engage young people in more than just being taken home by the police. We need to bring those young people into educational programmes that are run by or involve their peers. In many cases, having a criminal justice system or a public security system that lifts young people, takes them home and presumes that their parents will care will not get us far. We need to develop things further.
I hope that the forthcoming drug and alcohol strategy will have a renewed emphasis on children and families and on supporting those who have problems. I support the motion and welcome the opportunity that it has provided for tonight's debate.
As someone who has never been "inflamed with wild notions", I congratulate my colleague Dr Bill Wilson on bringing this important debate to the chamber. The approach that is described in the motion should be considered in depth because it is an innovative example of the kind of subject the Scottish Parliament should investigate. However, I condemn Dr Wilson for stealing the quote from Plato that I intended to use in the debate, and for stealing my title of Statto of the Parliament by reeling off so many statistics in such a short period.
I know exactly what Bill Wilson was talking about. When I was at university, I was part of a group of four. Two of my friends were quite heavy drinkers, but I was teetotal until I was 23 years old because of my family background, and my friend Michael was one of those people who seem to think that, to impress people, they have to be seen drinking. The problem was that he did not like drink. We would go into a bar and, of course, we would all buy rounds. He would sit there sipping his pint. After an hour or so, about 2mm of his pint would have been drunk. He would then go to the bathroom and, miraculously, the pint would disappear. We knew that he had flushed the pint down the toilet. When we met him the following day, he would say, "I've got a terrible headache. I was really bevvied last night." That infantile attitude in a young adult did not make friends or influence people—we all joked about it—but he perceived that that was what young students did.
That is why it was important for Bill Wilson to highlight that a lot of students do not drink heavily. Many young people are concerned about their future, are extremely well behaved and care about their society and the planet. They care about lots of things: they do not want to smoke their lungs out, to drink themselves to death or to take drugs.
One difficult issue that we face is the sensationalism of the press: the lurid approach to life whereby people are plucked from obscurity and put on a pedestal for a short time, which leads to their lives being damaged in the long run. Their 15 minutes of fame—the Andy Warhol idea—often results in their being pictured in a variety of relationships or perhaps taking their clothes off in public. That has an impact on young people—younger people are much more sexualised than they were in the past and are much less innocent. There is a real problem of responsibility in the media.
None of my friends at school smoked, and I have never tried a cigarette or understood the concept of smoking at all. My parents did not smoke either. However, in a crowd where people smoke or drink a lot, there is obviously peer pressure to do that. I hope that with the reduction in smoking figures, particularly among boys, we are at the trigger point and it is now becoming extremely unfashionable in certain circles to smoke.
I would like to see it become much more unfashionable among young people to drink, particularly drinking products such as Buckfast in the street. Just a couple of days ago at a public meeting, someone said to me that if Buckfast was called Honeysuckle Juice, people would not drink it. "Buckfast" has a macho sound to it that perhaps attracts people that it should not.
The issue is an important one that we should pursue in Parliament. I welcome once again Dr Bill Wilson's having brought it forward for debate, and I am sure that the minister will be positive in her summing up.
I welcome the debate in the name of Bill Wilson, and his Rev I M Jolly introduction.
The research is much more interesting than I found it to be at first glance. Any research that can contribute to the understanding of alcohol intake and the behaviour of young people is helpful. That is particularly the case given that 27 per cent of the population use alcohol harmfully, compared with the 1 per cent of the population who use drugs harmfully—figures that were given in this week's Health and Sport Committee meeting.
I welcome the research paper from the University of Paisley by John McAlaney and John McMahon. There is in Scotland a culture of drinking that has to be understood and addressed. Although we could have lifted the American research, there is no doubt that the higher legal age for purchasing and the less tolerant attitude of students and university officials in America means that that research does not wholly apply to Scotland. As Bill Wilson stated, the research found that an individual's perception of normal behaviour in others is a determinant in his or her own behaviour. It is also important to acknowledge the higher proportion of mature students who participated in the Paisley research and that the female to male ratio was 2:1.
The significant positive relationship between the individual's consumption and his or her perception of others' consumption appears to be stronger when a person drinks more than seven drinks on a night out. That compares to the individual who has fewer than seven drinks and who perceives that their personal drinking behaviour is greater than the norm in other students. In other words, the lower the individual's alcohol intake, the lower is their perception of drinking in others, and the higher their intake above seven drinks a night, the higher is their perception of what is the norm of drinking among other students. The research paper states:
"Heavy episodic drinking behaviour itself may increase how common individuals perceive the behaviour to be in others—possibly as a way to justify their own consumption to themselves".
The theory applies also to the frequency of drunkenness. Students who were drunk on fewer than two or three days a week perceived the norms of drinking by other students to be lower, whereas those who were drunk more than once a week perceived the norms of drinking by others to be significantly greater. In my view, those two points represent the core of the issue. The research shows that many students strive—as Kenny Gibson said—to match an inflated perception of what is normal drinking for a student. The report says that 52 per cent of respondents at Paisley university stated that the majority of students got drunk at least twice a week. However, that is more than four times greater than the real figure, which the report says is 12 per cent. That reinforces what I regard as being the central point, which is that there seem to be genuine misperceptions. The end result is that the alcohol intake of many people is being increased as they try to keep up with their peers, even though their peers are actually drinking less than them.
I hope that the research will be utilised to underline public health messages, advertising and information campaigns for students and others. However, the research is confined to the university sector. It would be interesting to find out whether the analysis applies equally to the drinking behaviour of people of all ages and people from all walks of life. Nonetheless, the research is an excellent contribution to the debate on alcohol consumption. I thank Bill Wilson for bringing it to the attention of Parliament.
I congratulate Bill Wilson on securing this members' debate and on bringing such an interesting and potentially beneficial motion before the Parliament. Several members have used statistics. I am afraid that I will not be able to use any—although Dr Wilson handed me a small summary of his statistics before the debate began. I have not had the chance to dip into it yet, but I promise him that I will look at it.
Later this evening, many MSPs will attend the politician of the year awards dinner. No doubt good food will be eaten and a few drinks will be had. One or two humorous stories may even emerge over the few days following the dinner. We all know how stories work: they are often funnier and more entertaining when exaggeration and embellishment are added to provide spice and seasoning. In Scotland, the cement that binds a good story is often the special ingredient of alcohol. I am always surprised by how many times grown adults exaggerate and embellish their behaviour—even their mild misdemeanours. It seems to make us far more windswept and interesting. The cement that binds stories is often alcohol—not only when they are created, but when they are retold.
"How many drinks did you have last night?" That has been a common question over the years, but how many people give an honest answer? The answer is often, "I can't remember, but it was a fair few," or, "A bucketload." Why do people exaggerate? Why, according to the statistics, do teenagers in particular exaggerate? That is a vexed question, the answer to which likely involves a heady cultural mix, the ingredients of which would no doubt keep many a sociologist in employment for many a year. However, it appears that not only do we exaggerate our own stories, we believe other people's exaggerations.
Kenny Gibson's story of his student days struck me. I had a similar good friend who liked going out and participating in the drinking of alcohol. After two or three drinks that was him—that was his limit—but he would never say no to a pint of lager, and he would have to be seen to drink it. However, he did not drink it, and I knew that he did not drink it. He felt that, socially, for the company, he had to pretend that he was partaking of alcohol along with everyone else.
It is of little surprise that when adults cannot have a mature, honest and responsible relationship with alcohol, our perceptions of the social norms of alcohol consumption become hazy, to say the least. It is also of little surprise that when it comes to the drug of choice for many, people overestimate their peers' consumption. Worryingly, the gap between the real social norm for consumption and the perceived social norm may fuel some to drink more heavily. After all, we all, in our own way—even the most rebellious among us—like to be part of the social norm and to be accepted by our peers. Surely we should tackle the social misconceptions that may lead to increased consumption of drugs and alcohol.
I am sure that there are a number of drug and alcohol awareness initiatives in educational institutions. However, any tailoring of them—or, if need be, the provision of stand-alone projects that deal openly and honestly with our relationship with drugs and alcohol, including challenging misperceptions with regard to peer groups—would surely be worth while. I therefore thank Bill Wilson once more for lodging the motion. I am more than happy to commend it to the chamber.
Like previous speakers, I congratulate Bill Wilson. It is important and entirely appropriate that the Parliament has an opportunity to discuss alcohol consumption from another perspective. I trust that it is coincidental that it has occurred on the same night as the parliamentarians' dinner—we should all take a sober lesson from that.
We all know the problems that alcohol poses for Scotland. All speakers have been armed with a litany of statistics and figures to indicate the negative social and medical effects of excessive consumption. It is legitimate that, to a greater or lesser extent, those statistics are founded in quantitative empirical methodology—that is perfectly understandable. There is nothing easier for people to get a grip on than facts and figures, although it is all too easy for the media to twist those facts and figures in a way that suits the story that they want to tell.
It is a lot more difficult accurately to assess the qualitative effects—as members from professional fields will know, it is very complicated. Qualitative studies are longer term and take a lot more manpower and analysis. The methodology that is referred to in the motion presents us with an opportunity. Research from the Institute of Alcohol Studies indicates that, on their own, warning labels about the number of units have no effect. We need a panoply of tools to attack the issue. The methodology kindly presented to us by Bill Wilson is a way forward.
What motivates and stimulates the attitude that the purpose of consuming alcohol is solely to get falling-down drunk? It is not about socialising. It is not about easing digestion. It is not even about enhancing the enjoyment of entertainment. Other members have referred to the post-mortem discussions about nights out, many of which revolve not around the pleasant company, the food—good or otherwise—or the entertainment, but almost exclusively around how much alcohol was consumed. As Bob Doris said, there seems to be a perverse pride in telling tales of consumption to friends, colleagues and associates. Perversely, it is seen as heroic to claim to have drunk 15 pints or six shots. We feed that machismo.
We need to find a mechanism to scotch that attitude. Given the damage that alcohol does to our society, it is one of our major challenges. A strategy must include all the tools that are at our disposal. Attitudes can be changed, but it is often a slow process. We need look only at the other issues on which we have had to change attitudes—on using seatbelts, on consuming alcohol when driving or on wearing crash helmets when riding a motorbike—to know that it is a slow process.
Like other members, I welcome Bill Wilson's efforts to bring the methodology that is mentioned in the motion to our attention. I hope that ministers and cabinet secretaries take it forward as another tool.
I thank Bill Wilson for raising an extremely interesting topic, and I thank him and other members for their speeches. A number of points that we should all remember have sprung out of the debate. One is that the vast majority of young people are responsible, law-abiding citizens. Another is that good news often does not make good headlines, as Richard Simpson said. We must consider that in the context of how we deal with the media.
I congratulate Scotland's Futures Forum on holding an excellent expert seminar on the social norms approach back in October, at which the key speaker was Wesley Perkins, professor of sociology at Hobart and William Smith Colleges in New York, who has championed the social norms approach for a number of years.
All of us will recall feeling pressure, as young people, to fit in with the crowd, but the social norms programmes in the United States have exposed that the reality of the crowd's behaviour can be misunderstood, and that such misconceptions can reinforce negative behaviours, such as binge drinking or smoking. As members have said, exposing those misconceptions for what they are and reinforcing majority behaviour are the keys to the success of the social norms approach. The recent study that was done at the University of Paisley draws some comparisons with the results from the United States, in that students tend to overestimate the alcohol consumption of their peers, and suggests that similar interventions could have positive results in Scotland. I look forward to reading the report of the wider study in January.
However, I offer a word of caution. Although the evidence from the United States shows that that approach has merit, we know that we face significant challenges in Scotland in relation to attitudes and behaviour, and that our problems are complex. As Mary Scanlon said, we should bear in mind the fact that the cultural relationship that people in Scotland have with alcohol is different from the one that exists in the US. We also have some vivid statistics on alcohol-related illnesses and deaths, to which I will return shortly.
If we are to achieve sustainable culture change, we need to educate our young people so that they can make informed, responsible decisions about behaviour such as substance use or risky sexual activity. We must empower them to make sensible choices to ensure not only that they safeguard their health, but that they do not fall foul of other problems, such as those that are linked to alcohol misuse, which include antisocial behaviour, drug misuse or unprotected sex.
Government has an important role to play in supporting people to make healthier choices. We want to ensure that we communicate the benefits that our behaviour can have for our health in a clear and unambiguous way. Hugh O'Donnell highlighted the importance of that. We might be used to thinking of Government health improvement messages as warnings about what we should not do or what we should do less of, but it is just as important to give individuals and families, particularly those in our most disadvantaged communities, the tools to make more positive choices.
For that reason, we are reviewing our health improvement communications, to ensure that future campaigns offer a clear, supportive and inclusive way to positive behaviour that will lead to a healthy life. That means taking a more strategic approach that recognises that all the messages to be more physically active, to stop smoking, to eat more healthily and to consume alcohol sensibly have at their heart a basic requirement—that we feel confident about taking control of our lives and positive about making achievable changes. That is particularly important for those people who are likely to suffer from health inequalities. Our approach will take empowering individuals as its first principle and will have improving well-being, both mental and physical, as its goal.
We are keen to look at evidence-based examples from around the globe and to examine whether they can be tailored for Scotland, so I have asked my officials to consider the social norms approach in more detail, with a view to conducting a pilot study on alcohol, if that would be feasible. Although the prime focus might be on alcohol initially, we will explore the scope for widening out that work to include smoking and sexual health. I will take account of the suggestions that Bill Wilson and others have made in that regard.
However, as I said, we must recognise that Scotland does not have a healthy relationship with alcohol. The figures are stark: one Scot dies every six hours as a direct result of alcohol consumption and 35 people die each day as a result of smoking. We must acknowledge that we have a problem; the question is what we do about it. We are clear that a long-term, strategic approach is required if we are to tackle Scotland's complex relationship with alcohol and to denormalise excessive drinking and the behaviour that goes with it, just as we have sought to denormalise smoking. That fits in with the social norms approach.
It is encouraging that awareness is growing of the problems that alcohol misuse causes, which range from short-term and long-term physical and mental health harms to antisocial behaviour and the damage that is done to our communities and to all our efforts to help Scots and Scotland reach our full potential. We are on the right path.
Where do we go from here? We are committed to publishing a five-year smoking prevention action plan early next year that will aim to prevent young people from starting to smoke and becoming regular smokers. We will propose a wide range of measures, including some that are targeted at further education colleges and universities, in the light of the clear evidence that young people start to smoke or progress from occasional to regular smoking once they leave school. We will consider how the social norms agenda can help to reinforce the message about the number of young people who do not smoke and the message that not smoking is something to aspire to.
Work is under way on the long-term strategy to tackle alcohol misuse, which we aim to publish in the spring. Richard Simpson made an important point about involving young people. Following the recent debate on alcohol, we plan a summit on underage drinking that will involve young people directly in order to bed into the long-term strategy on alcohol their view on what works. We look forward to having their input.
There is no single approach or magic bullet, but we are determined to achieve a healthier Scotland. Nothing is off the agenda to help us to get there. Tonight's debate has made a welcome contribution.
Meeting closed at 17:41.