American College Health, November 01, 1996
The Perception of The Norm: A Strategy To Decrease Binge Drinking Among
P. Haines, MS, and Sherilyn F. Spear, PhD
A reduction in college students' binge drinking associated with an intervention
to change perceptions of drinking norms is described. The 5-year study
was conducted at a public residential campus of 23,000 students. A traditional
intervention proved unsuccessful, but a media campaign designed to change
student perceptions of the amount of binge drinking showed an 18.5%
drop in the number of students who perceived binge drinking as the norm
(from 69.7% to 51.2%) and a corresponding reduction in self-reported
binge drinking of 8.8% (from 43.0% to 34.2%). The apparent effectiveness
of this prevention effort suggested that changing college students'
perceptions of drinking norms may lower the proportion of students who
engage in binge drinking.
alcohol, behavior change, binge drinking, media, peer norms, prevention
In the late 1980s,
the Fund for the Improvement of Post-Secondary Education (FIPSE)
for the first time made federal funds available to colleges and universities
to provide direct services for programs to prevent substance abuse.
Historically, such funds could be used only for research or for demonstration
projects. In response to the FIPSE initiative, as well as to priorities
outlined in Healthy People 2000, Northern Illinois University (NIU)
applied for and received FIPSE funding in 1987 to target the problem
of binge drinking among college students.
on drinking behavior among college students indicated that 80% to 90%
of all college students drink alcohol. Forty percent to 45% of these
students engage in binge drinking[3-6]; that is, they drink five or
more drinks in "an evening" as part of a single drinking episode.
It is popularly
believed that heavy drinking among college students plays a role in
such other problem behaviors as date rape, vandalism, accidents, and
unintended sexual activity, and that heavy drinkers are at increased
risk for other problem behaviors.[7,8]
have been used in an attempt to prevent or reduce binge drinking among
college students, including teaching students refusal skills, clarifying
values, rewriting policies, increasing knowledge, and using peer education
and scare tactics. Nevertheless, assessments of these approaches have
provided little evidence that they are successful in preventing or decreasing
students' binge drinking.[9-14]
Faced with the apparent
ineffectiveness of existing prevention strategies in reducing college
students' binge drinking significantly, the health promotion staff at
NIU sought direction from a broad range of social psychology literature.
This effort led to a review of the work of Perkins and Berkowitz,
who reported significant discrepancies between the actual levels of
alcohol consumption among college students and the students' perceptions
of their peers' usual drinking levels. Students consistently overestimated
both the amount of alcohol other students routinely consumed and the
proportion of their fellow students who were heavy drinkers.
Perkins and Berkowitz's
findings suggested that students saw the higher levels of alcohol consumption
as the norm. Having perceived heavy or binge drinking as the "usual"
behavior of their peers, they may have been more likely to engage in
this "typical" behavior. That link between adolescents' perceptions
of the norm and their actual behavior is also suggested by the findings
of a number of other studies.[15,16] The most recent data, from a 1995
study by Evans et al that specifically targeted alcohol use, indicated
a relationship between adolescents' perceptions of the norm of peers'
health-related behavior and the individual's own behavior.
The health promotion
staff at NIU, building on the Perkins and Berkowitz theory, sought to
develop strategies to prevent binge drinking that focused on changing
students' perceptions of the typical drinking behavior of college students.
In addition, the staff sought a means of comparing the results of this
new strategy with traditional approaches targeting binge drinking. We
therefore designed a 5-year study to compare changes in perceptions
and in self-reported drinking behavior following implementation of traditional
approaches and our "change in perception of the norm" strategy.
The project began
in 1988 and continued through 1992. During Year 1 (1988), we collected
baseline data related to (a) students' perceptions of how many drinks,
on average, they thought most students have when they "party";
and (b) how many drinks, on average, the individual reported having
had when he or she partied.
During Year 2 (1989),
we implemented traditional prevention strategies, and during Years 3,
4, and 5, we implemented the strategy aimed at changing the students'
perceptions of the norm. We also collected data on students' perceptions
of their peers' drinking behavior and on the students' self-reported
drinking behavior, starting in 1988 (Year 1) and continuing through
1992 (Year 5).
Our Year 2 traditional
prevention campaign focused on binge drinking. It included educational
presentations in classrooms, at Greek houses, and in residence halls;
an extensive media and advertising campaign; implementation of new policies;
and awareness events. The strategies had three prominent themes: (a)
It's OK to abstain; (b) It's OK to drink in moderation; and (c) Heavy
drinking/intoxication cause harm to oneself and others.
During Year 3 (1990),
the university health service implemented a media campaign focusing
on the perception of heavy binge drinking as the norm among college
students. We conducted a major public information campaign to decrease
the number of students who believed that drinking six or more drinks
when partying was the normal practice. The campaign included display
advertisements as well as weekly classified advertisements in the campus
Throughout the school
year, we distributed fliers at student events that highlighted actual
drinking norms on campus. We also posted the pamphlets in areas with
heavy pedestrian traffic. In addition, we hired two students (the "Money
Brothers") to approach tables in the student union at lunch time
and in the residence halls during the dinner hour. The two students,
who were highly conspicuous, wore a costume consisting of dark glasses,
trench coats, and fedoras. They carried a briefcase filled with fliers
and $1 bills. At each table, the brothers loudly asked whether anyone
knew the proportion of NIU students who drank five or fewer drinks when
they partied. If a student answered correctly, that student received
a crisp $1 bill.
Whatever the answer,
all of the students at that and nearby tables were given a flier containing
the correct information. The Money Brothers appeared for 2 weeks during
each semester (4 weeks during the 9-month academic year). During Years
4 and 5 (1991, 1992), we continued the intervention to change the perceived
drinking norms. The only change we made was to update the statistics
on the NIU students' actual drinking behavior.
We collected survey
data every April over the 5-year period, using the figures from Year
1 to establish baseline measures of both perceived drinking levels of
peers and self-reports of actual drinking levels. We used data from
Years 2, 3, 4, and 5 to monitor perceptions of peer drinking and actual
drinking behavior after the two interventions, namely, traditional programs
in Year 2 and the changing-the-norm strategy in Years 3, 4, and 5. We
also used national data on drinking among college students to monitor
the overall longitudinal drinking trends in this population.
We recognize that
it is difficult to be completely confident that different outcomes are
attributable to the interventions because (a) the students were not
randomly assigned to the intervention and (b) the interventions occurred
in different years.
We adapted the survey
instrument from three previous studies: the National Institute of Drug
Abuse (NIDA) study of alcohol, tobacco, and drug use; the Perkins
and Berkowitz study at Hobart and William Smith Colleges; and the
studies of drinking consequences conducted by Engs and Hanson. We
used the same self-report questionnaire, which consisted of approximately
45 items, throughout the project. A member of the university health
services health promotion staff distributed and collected the questionnaires
in each class.
We used two questions
to measure the perception of drinking behavior and the students' actual
drinking behavior To determine the students' perceptions of peer drinking
norms and to verify the discrepancy between perceived and drinking reported
by Perkins and Berkowitz, we asked, "How many drinks, on the average,
do you think most students have when they 'party?'" The second
question, designed to collect data on actual drinking behavior, was
"When you 'party,' how many drinks do you have on the average?
(One drink is defined as a beer, a glass of wine, a shot of liquor,
or a mixed drink.) State your best estimate." Responses to both
questions were A = 0; B = 1-2; C = 3-5; D = 6-9; E = 10+.
We labeled those
who gave responses indicating six or more drinks (D and E) binge drinkers,
those in the one to five range were considered moderate drinkers, and
students who marked the zero were called abstainers. Additional questions
gathered a series of demographic data from the students.
Members of the university
health services health promotion staff administered the questionnaires
in undergraduate general education classes. We chose these classes because
they tended to have large enrollments and were required for all undergraduate
students at the university. This convenience sampling approach gave
us easy access to large numbers of students and increased the likelihood
of high response rates. General education classes were also more likely
to reflect the overall composition of the NIU undergraduate student
body than were smaller, major-specific courses. An anticipated bias
in the sample was that general education courses might have a higher
proportion of 1st-and 2nd-year students and fewer upper division participants
than the undergraduate population as a whole.
5-year period of the project, the average return rate was 89% of the
distributed surveys, varying from 85.9% in 1988 to 91.6% in 1989. See
Table 1 for a comparison of the characteristics
of sample respondents with the university's overall population. In general,
the data indicate that the sample was representative of the undergraduate
population in terms of gender and ethnicity; as anticipated, however,
the participants were slightly younger and more likely to be undergraduates
than the overall university student population.
For both the NIU
population as a whole and the sample, somewhat more women (57%) than
men (53%) were represented. In addition, the proportion of minority
students attending NIU increased during the late 1980s and early 1990s.
This trend in minority student enrollment was evident in the sample
slightly earlier than it was in the data for the NIU population as a
whole. For the first 2 years of the study, the proportion of minorities
in the annual samples exceeded the proportion in the overall NIU population.
One possible explanation for this difference is that the sample overrepresented
undergraduates, particularly 1st- and 2nd-year students, who were in
the first classes to include the increasing proportion of minorities
that, over time, characterized the entire NIU population.
Table 2 and Table 3 show
findings on the two dependent variables of interest in this study. These
are (a) the students' perceptions of the norm of drinking behavior among
their peers, and (b) the students' self-reported drinking behavior.
We used chi-square tests to compare the sample data relative to these
two variables. That is, to determine whether students' perceptions of
the norm of drinking behavior changed following the intervention that
targeted the perception. Second, we used chi-square analysis to compare
baseline data on the number of students who reported binge drinking
after the traditional intervention and again after the intervention
aimed at changing the perception of the norm.
of the Norm of Drinking Behavior
to the question about the number of drinks they thought other students
consumed when at a party (the norm) are shown in Table 2. Four hundred
forty-nine students (69.7%) in the 1988 baseline-year sample thought
that fellow students consume 6 or more drinks, on average, at a party.
In other words, 69.7% of the students believed binge drinking to be
During 1989, when
we implemented a traditional strategy, 540 (69.3%) of the respondents
continued to believe that binge drinking is the norm. Thus, we found
that the traditional strategy did not appear to bring about any significant
change in the students' perceptions that binge drinking is the normal
In 1990, we implemented
the strategy to change the perception of the norm. Following that intervention,
we found a significant drop in the proportion of students who believed
binge drinking to be the norm, Chi[sup 2](1, N = 644) = 54.76, p <
.001. Thus, 57% of the students in 1990, compared with 69.7% in 1988,
perceived binge drinking as the norm. We continued the intervention
to change perceptions of the norm during the next 2 years; the decrease
in the number of students who perceived binge drinking as the norm was
sustained. Compared with 1988 (the baseline year), significantly fewer
students than expected believed that binge drinking is the norm, Chi2(1,
N = 792) = 127.42, p < .001, and in 1992, Chi2(1, N = 814) = 132.37,
p < .001.
The decrease in
the proportion of the students who viewed binge drinking to be the norm
continued as the intervention targeting that perception continued. This
change in perceptions followed the implementation of an intervention
focusing on students' perceptions of typical student drinking behavior.
Based on our findings in this survey, we suggest that (a) the intervention
may have influenced students' perceptions; and (b) it would be reasonable
to examine the additional data on self-reported drinking behavior and
search for the links, if any, between perception and behavior.
of NIU Samples
drinking behavior of NIU students sampled each year from 1988 (the baseline
year) through 1992 are shown in Table 3, making it possible to compare
the year after the traditional intervention (1989) with the years following
the intervention to change the perception (1990-1992).
In 1988, the baseline
year, 277 students (43.0%) reported they engage in binge drinking when
they party. In 1989, the NIU health promotion staff used traditional
intervention strategies in an attempt to reduce binge drinking on campus.
That same year, 349 students (44.8%) self-reported binge drinking--six
or more drinks, on average--when they party. The percentage of binge-drinking
students in the 1989 sample was not significantly different from the
self-reported binge drinking in the baseline year.
In 1990, the NIU
health promotion staff implemented our change-in-perception-of-the-norm
strategy. We performed a chi-square test to compare the 1990, 1991,
and 1992 samples with the results from 1988, the baseline year, and
from 1989, the traditional intervention year. The analysis indicated
that significantly fewer students reported binge drinking in 1990 than
had done so in 1988, Chi[sup 2](1, N = 716) = 8.23, p < .01. Similarly,
in comparison with the 1988 data, sample data from 1991 indicated that
291 students, rather than the expected 340 students, reported binge
drinking, Chi2(1, N = 792) = 12.37, p < .01. A comparison of the
1992 data with the baseline figures indicated that 278 students reported
binge drinking, rather than the 350 that could have been predicted from
the 1988 data, Chi2(1, N = 814) = 25.35, p < .001).
The percentage of
students reporting binge drinking in 1989 was slightly, though not significantly,
higher than the percentage of students reporting this behavior in 1988
(binge drinking 1988 = 43.0%; 1989 = 44.8%). Thus, the expected frequencies
of self-reported binge drinking for 1990 through 1992 would be slightly
higher if we used the 1989 data rather than the 1988 data to calculate
expected frequencies for the 1990 to 1992 samples. Significantly fewer
students reported binge drinking in 1990 through 1992 than might have
been anticipated on the basis of the sample data from 1989, the year
of the traditional intervention. In each of the years in which we implemented
our change-in-perception-of-the-norm strategy, significantly fewer students
than expected reported binge drinking, compared with students in 1988
(baseline year) and in 1989 (the traditional strategy year).
the NIU and National Survey Samples
Although the change
in self-reported binge drinking occurred only after we implemented our
strategy to change the perception of the norm, the quasi-experimental
design of the study does not allow researchers to rule out all other
possible explanations for this change. Some encouragement for continuing
to explore the effect of this intervention can be gained by comparing
the NIU results with national data from the Monitoring the Future
study for the same period. Basically, the comparison suggests that during
the years when the number of students in the NIU sample who reported
binge drinking decreased, no such change was taking place nationally.
Comparison of the NIU data and the US data (Table 3) for 1988 and for
1989 suggests that there were no significant differences in self-reported
binge drinking of NIU students and students in the national sample.
In 1990, following
the implementation of our effort focused on changing the perception
of the norm, 37.6% of the NIU sample versus 41.0% of the US sample reported
engaging in binge drinking. Again, we used chi-square analysis to compare
data from the two samples. The 3.4% difference in reported binge drinking
behavior between the two samples was small though statistically significant,
chi[sup 2](1, N= 716) = 3.33, p < .10. The NIU strategy to change
perceptions of the norm was implemented again in 1991. Data from 1991
indicate that 291 students (37.6%) in the NIU sample and 604 respondents
(42.8%) in the US sample reported binge drinking behavior. In comparison
with the US sample, significantly fewer NIU students than expected reported
binge drinking, chi2(1, N = 792) = 11.88, p < .001. In 1992, the
3rd year we used the changed perception intervention, the number of
NIU students reporting binge drinking behavior (278) was significantly
lower than the number expected to report that behavior on the basis
of the US data, chi2(1, N = 814) = 13.01, p < .001 for the same year.
Finally, it should
be noted that the definition of binge drinking in the NIU study was
six or more drinks, whereas the Monitoring the Future researchers used
a binge drinking measure of five or more drinks. Nevertheless, the most
important aspect of this comparison is that (a) there were no significant
differences between the NIU sample and the US sample in 1988 and in
1989; (b) in 1990 through 1992, there were no changes in the proportion
of the US sample reporting binge drinking, whereas a significant decrease
occurred within the NIU sample; and (c) in 1990 through 1992, significantly
fewer NIU students reported binge drinking than would be expected if
we based our prediction on data from the US sample.
results of the study, we must look at some limitations that provide
the context within which a careful discussion of the findings must take
place. The limitations flow from two characteristics of the study: the
quasi-experimental research design and our reliance on the students'
First, in this quasi-experimental
design, the comparison groups included different cohorts of NIU students
and respondents in the Monitoring the Future study. The cohorts of NIU
students who responded to the questionnaire in 1988 and in 1989 may
have been different from the cohorts responding in the study in 1990
through 1992, the years during which we carded out the program to change
the students' perceptions of drinking norms.
In reality, we do
not know about actual differences across these cohorts. For example,
the 1990 to 1992 cohorts' responses may have reflected a cumulative
effect of interventions at NIU or exposure to prevention programs that
predated the NIU students' experiences. Although the data from NIU 1990-1992
respondents are parallel in time with the 1990-1992 Monitoring the Future
data, the likelihood of differences in the experiences of the two sets
of cohorts must be recognized. Thus, it is possible that factors other
than the interventions influenced the outcomes of the NIU data and were
unique to NIU and, therefore, were not experienced by respondents in
the national monitoring study.
Second, it is important
to recognize that the behaviors were self-reported. Concerns about the
reliability of self-reported data are well known. In this study, the
particular areas of concern included unreliable recall or students'
misperceptions of their own behavior and the tendency to adjust reported
behavior to give the "expected" answer. It is always possible
that multiyear studies with repeated data collection points may heighten
respondents' awareness of the study's purpose, and that such awareness
may influence a respondent to report behaviors that reflect the intended
outcome of the research. Both the limitations of the quasi-experimental
design and reliance on self-reports should be kept in mind in considering
the discussion of the study results.
The findings in
this study are consistent with the earlier work of Perkins and Berkowitz.
That is, a significant difference exists between students' perceptions
of typical drinking behavior among college students and the self-reported
drinking behavior in this population. Data gathered during Year 1 (the
baseline year) of the study indicate that students significantly overestimated
the proportion of their peers who engage in heavy or binge drinking
Our purpose was
to go beyond the Perkins and Berkowitz findings and to determine
whether it was (a) possible to change students' perceptions, and (b)
whether a change in perceptions would be accompanied by a change in
behavior. Our findings indicated that after we implemented the change-in-perception-of-the-norm
strategy, the proportion of students who reported heavy or binge drinking
as the norm decreased significantly. In addition, we also found a significant
drop in the proportion of students who reported engaging in binge drinking
after we implemented the strategy to change perceptions.
Although these preliminary
findings must be considered in the context of the limitations discussed
earlier, they are encouraging. Outcome data on more traditional strategies
indicated no significant change in drinking behavior.[9-14] Findings
from Year 2 (1989) of the NIU study were consistent with the earlier
studies that found no significant changes in drinking behavior following
use of traditional strategies. In addition, we found no change in the
proportion of students who viewed binge drinking at parties as normal
behavior when we compared data from the baseline year and the year when
we used traditional approaches.
Changes in both
the perception of others' behavior and self-reported binge drinking
followed only after we implemented the strategy to change the perception
of the norm. We felt encouraged to continue to implement and assess
the program to change perceptions when we compared reported drinking
behavior data from the NIU students with that reported in the national
assessment for the same years. That is, between 1988 and 1992, no significant
changes took place in the proportion of participants in the national
sample who reported engaging in heavy or binge drinking, and no significant
change in the proportion of students in the NIU sample occurred in those
2 years. However, after we implemented the strategy to change perceptions
in 1990, 1991, and 1992, fewer students reported that they engage in
The absence of change
in self-reported binge drinking in the Monitoring the Future samples
lends additional support to the results that imply that the self-reported
decrease in NIU student drinking behavior may be attributable to the
intervention rather than to a national trend of decreasing heavy or
Although the results
of this preliminary work are encouraging, it must be recognized that
they are in no way definitive. Nevertheless, they suggest the potential
importance of altering the perception of what is normative for one's
peers. The findings also raise cautions for health promotion interventions
that may contribute to the perception that binge drinking among high
percentages of college students is normal. These results indicate that
such interventions may be self-defeating. Most important, the data suggest
the need for further work focusing on the implications of perceptions
for health-related behavior.
The health promotion
and research team at NIU is now examining data collected from student
samples between 1993 and 1996. If these data are consistent with the
findings of this preliminary study, more significant recommendations
for health promotion interventions that target binge drinking and other
risky behaviors will be warranted.
Table 1: Comparison
of Overall Student Population at Northern Illinois University (NIU)With
Study Sample, 1988-1992
TABLE 2: Northern
Illinois University Students Who Perceived Binge Drinking as the Norm,
1988-1992, During a Study of Prevention Strategies
TABLE 3: Students'
Self-Reports of Binge Drinking, 1988-1992, Comparing Northern Illinois
University (NIU) With a National Sample During a Study of Prevention
- The Fund for
the Improvement of Postsecondary Education; Drug Prevention Programs
in Higher Education; Information and Application Procedures. The FY
1992 Institution-wide Program Competition. Washington, DC: Office
of Postsecondary Education; 1992.
- Healthy People
2000: National Health Promotion and Disease Prevention Objectives.
Washington, DC: US Dept Health and Human Services, US Public Health
- Engs RC, Hanson
DJ. University students' drinking patterns and problems: Examining
the effects of raising the purchase age. Public Health Rep. 1988;103(6):667-673.
- Rapaport RJ,
Cooper A, Leemaster H. Student Alcohol Misuse: The Negative Effects
of Drinking in College. Mount Pleasant, MI: Counseling Center, Central
Michigan University. 1984; 1-19.
- Hughes SP, Dodder
RA. Alcohol consumption patterns among college populations. J Coll
Student Personnel. 1983;24: 247-264.
- Johnston LD,
O'Malley PM, Bachman JG. National Survey Results on Drug Use From
the Monitoring the Future Study, 1975-1992. Vol. 2. Rockville, MD:
National Institute on Drug Abuse, US Dept Health and Human Services.
- Wechsler H,
Davenport A, Dowdall G, Moeykens B, Castillo S. Health and behavioral
consequences of binge drinking at college: A national survey of students
in 140 campuses. JAMA. 1994; 272(21):1672-1677.
- Canterbury RJ,
Grossman S J, Lloyd E. Drinking behaviors and lifetime incidents of
date rape among high school graduates upon entering college. College
Student J. 1993;27(1):75-84.
- Perkins HW,
Berkowitz AD. Perceiving the community norms of alcohol use among
students: Some research implications for campus alcohol education
programming. Int J Addict. 1986; 21(9 & 10):961-976.
- Kraft DP. The
prevention and treatment of alcohol problems on a college campus.
J Alcohol Drug Educ. 1988;34(1):37-51.
- Magner DK. Alcohol-Related
Problems Have Not Decreased on Most College Campuses, Survey Indicates.
Chron Higher Educ. 1988;35(11):A35,37.
- Drug Abuse Prevention:
Federal Efforts to Identify Exemplary Programs Need Strong Design.
Washington, DC: 1991; GAO/PEMD-91-15.
- Goldstein HK,
Di Nitto D. Some methodological problems. Solutions and findings from
evaluating risk-reduction projects. J Drug Educ. 1982;12(3):241-253.
RL. The effects of school-based substance abuse education: A meta-analysis.
J Drug Educ. 1988;18(3):243264.
- Sherman SJ, Presson
CC, Chassin L, Corty E, Olshavsky R. The false consensus effect in
estimates of smoking prevalence: Underlying mechanisms. Pers Soc Psychol
- Ellickson PL,
Hays RD. Beliefs about resistance, self-efficacy and drug prevalence:
Do they really affect drug use? Int J Addict. 1990-1991;25(11A): 1353-1378.
- Evans N, Gilpin
E, Farkas AJ, Shenassa E, Pierce JP. Adolescents' perceptions of their
peers' health norms. Am J Public Health. 1995;85(8):1064-1069.
of the information presented on this page were originally prepared by Michael
Haines and Richard Rice and are printed here with their permission.