Environmental Management A Comprehensive Strategy for Reducing Alcohol and Other Drug Use on College Campuses William DeJong Cheryl Vince-Whitman Tom Colthurst Maggie Cretella Michael Gilbreath Michael Rosati Karen Zweig A publication of the Higher Education Center for Alcohol and Other Drug Prevention Funded by the U.S. Department of Education ------------------------------------------------------------------------ Acknowledgments The authors are grateful to Lavona Grow, U.S. Department of Education, for her helpful comments on an earlier draft of this publication and to members of the Review Group for the Higher Education Center for Alcohol and Other Drug Prevention for their advice on the conceptual framework described here. For further information contact: The Higher Education Center for Alcohol and Other Drug Prevention Tel.: (800) 676-1730 Fax: (617) 928-1537 Website: http://www.edc.org/hec/ E-Mail: HigherEdCtr@edc.org Development of this publication was supported by contract number SS95013001 between the U.S. Department of Education and Education Development Center, Inc., and by a grant from the Robert Wood Johnson Foundation. The views expressed in this publication are those of the authors and do not necessarily reflect the official position of the Department or the Foundation. 1998 The Higher Education Center for Alcohol and Other Drug Prevention Education Development Center, Inc. 55 Chapel Street Newton, Massachusetts 02458-1060 ------------------------------------------------------------------------ Contents * Preface * Introduction * Lessons from Prevention Research * Environmental Management: A Public * Health Perspective * Environmental Management: A Case Law Perspective * Spheres of Action for AOD Prevention o Addressing Institutional Factors o Addressing Community Factors o Addressing Public Policy * Conclusion * Notes ------------------------------------------------------------------------ Preface The Higher Education Center for Alcohol and Other Drug Prevention was established by the U.S. Department of Education in 1993 to assist institutions of higher education in developing and carrying out alcohol and other drug (AOD) prevention policies and programs that will promote campus and community safety and help nurture students' academic and social development. To accomplish this mission, the Center seeks to increase the capacity of postsecondary schools to develop, implement, and evaluate programs and policies that are built around environmental management strategies. Environmental management means moving beyond general awareness and other education programs to identify and change those factors in the physical, social, legal, and economic environment that promote or abet alcohol and other drug problems. Clearly, stemming the use of alcohol and other drugs is not something that college administrators alone can achieve. Top administrators, especially presidents, must exercise leadership, but their success will depend ultimately on their ability to build a strong coalition of both on-campus and community interests. The better AOD prevention programs are campuswide efforts that involve as many parts of the college as possible, including students, staff, and faculty. For this reason, the Center emphasizes team-focused training and technical assistance work. Building coalitions with local community leaders is also key. College campuses do not exist in isolation. AOD prevention planners need to collaborate with local leaders to limit student access to alcohol, prevent intoxication, and support the efforts of local law enforcement. The Center therefore seeks to motivate and train academic leaders to work with local community representatives, while also joining with national organizations that urge local coalitions to increase their outreach to academic institutions. Specific Center objectives include promoting (1) college presidential leadership on AOD issues; (2) formation of AOD task forces that include community representation; (3) reform of campus AOD policies and programs; (4) a broad reexamination of campus conditions, including academic standards and requirements, the campus infrastructure, and the academic calendar; (5) formation of campus and community coalitions that focus on environmental change strategies; and (6) the participation of individuals from the higher education community in state-level and other associations that focus on public policy. The Center also seeks to increase the capacity of colleges and universities to conduct ongoing process and outcome evaluations of AOD prevention activities, both on campus and in the surrounding community. This publication represents one piece in a comprehensive approach to AOD prevention at institutions of higher education. The concepts and approaches it describes should be viewed in the broader context of prevention theory and the approaches affirmed by the U.S. Department of Education and promoted by the Center in its training, technical assistance, publication, and evaluation activities. For information on Center services, please contact: The Higher Education Center for Alcohol and Other Drug Prevention Tel.: (800) 676-1730 Fax: (617) 928-1537 Website: http://www.edc.org/hec/ E-Mail: HigherEdCtr@edc.org ------------------------------------------------------------------------ Introduction The mission of the Higher Education Center for Alcohol and Other Drug Prevention is to assist institutions of higher education in developing and carrying out alcohol and other drug prevention policies and programs that will foster students' academic and social development and promote campus and community safety. In 1989, a survey of college and university presidents found that 67 percent rated alcohol abuse to be a "moderate" or "major" problem on their campus.(1) Nothing has transpired in the past nine years to assuage the presidents' concerns. According to a 1993 Harvard study of U.S. college student drinking, 44 percent of students at four-year institutions engaged in binge drinking during the two weeks prior to the survey.(2) For men, binge drinking was defined as having five or more drinks in a row, and for women as having four or more drinks in a row. About half the binge drinkers, or about one in five students overall, were frequent binge drinkers-- that is, they had been binge drinking three or more times in the previous two weeks.(3) Data from the Core Institute confirm that nearly half of U.S. college students engage in heavy episodic drinking.(4) Despite the concerns of college presidents, heavy episodic or binge drinking on college campuses has often been viewed as a rite of passage for young adults. Some educators have assumed that most heavy drinkers, if left alone, will learn from their mistakes and then approach alcohol consumption with a greater sense of responsibility. This sanguine view not only overlooks the deaths and injuries that student drinkers experience each year but also their negative impact on other students and campus life in general.(5) Too often, the majority of students on most campuses, those who drink in moderation and those who abstain, are left to fend for themselves against the inconsiderate, insulting, intimidating, and sometimes criminal behavior of the student binge drinkers around them. Recent news on illicit drug use by America's young people has been discouraging. The 1996 edition of the Monitoring the Future study, an annual survey of American junior high and high school students, showed that the proportion reporting use of any illicit drug in the twelve months prior to the survey continued a steady increase that first began in the early 1990s. The main culprit is marijuana, which accounted for much of the overall increase.(6) Many of these students are eventually headed for college. The Core Institute's recent surveys of college students also show an increase in marijuana use, which has been accompanied by a decrease in the percentage of students who see the drug as a "great risk"(7) The purpose of this publication is to present a comprehensive strategy for alcohol and other drug (AOD) prevention in higher education called environmental management. Educational programs are a necessary but insufficient preventive measure. Also required are efforts to change the physical, social, economic, and legal environment that affects AOD use, which in turn can be influenced through a combination of institutional, community, and public policy change. Programs for early identification, referral, and treatment of problem drinkers are another essential part of the equation. In outlining this framework, the publication presents a set of priority activities for college officials to consider as part of a broad-based approach to AOD prevention. ------------------------------------------------------------------------ Lessons from Prevention Research Historically, institutions of higher education (IHEs) have focused on education and intervention strategies oriented to individual students. This approach has been ideologically driven.(8) Alcoholism, problem drinking, and drug addiction are commonly viewed in the United States as problems that arise out of human weakness. The danger of alcohol and other drugs is recognized, but those who develop problems are thought either to have brought it on themselves or to have been unlucky in their genetic inheritance. This view is consonant with a U.S. ideology that values individualism and self-determination.(9) Typical campus prevention efforts include general awareness programs during freshman orientation, awareness weeks and other special events, and peer education programs. Faculty at some schools have begun to incorporate AOD-related lessons into their courses, a process known as "curriculum infusion."(10) All of these programs are based on the premise that AOD problems on campus result from the ignorance of individual students about local, state, and federal laws and the dangers of AOD use. Evaluations of college-based educational programs are rare, but work in other school-based settings suggests that, while these types of educational strategies are necessary, they are insufficient by themselves.(11) Higher education officials have begun to explore the use of campus-based mass media to communicate educational messages to students. Most of this work has focused on providing more accurate information about actual levels of alcohol use on campus.(12) This strategy is grounded in the observation that students tend to overestimate the number of their peers who drink heavily. To the extent that this misperception drives normative expectations about alcohol use, and to the extent that those expectations drive actual use, it is important that the misperception be corrected.(13) A study at Northern Illinois University suggests that this approach to changing the social environment has great promise as a prevention strategy, but more definitive research is still needed.(14) Harm reduction programs are another mainstay of campus-based prevention. For example, several campuses have installed programs that encourage students to separate the acts of drinking and driving, including designated driver and safe rides programs. Worries about students driving under the influence are justified, but students who engage in high-risk drinking but do not drive after drinking also face significant health and safety risks. What is also necessary, then, is a more general approach that focuses on changing a broad array of environmental conditions that currently encourage students' high-risk drinking.(15) One of the chief lessons taught by nearly two decades of prevention research is the need for a comprehensive approach, one that not only addresses the specific educational needs of individuals but also seeks to bring about basic change at the institutional, community, and public policy level.(16) This approach is grounded in the firmly established principle that the decisions that people make about alcohol and other drug use will be shaped by the physical, social, economic, and legal environment that in turn can be shaped by a committed group of local prevention advocates, higher education officials, government officials, and others. Consistent with current prevention research, we believe a broader approach to student alcohol and other drug use is needed, one that reflects a more complete understanding of how societal conditions drive AOD use and the magnitude of AOD-related problems. The fact is that students receive "educational" messages from a number of sources, not just the classroom, and until these messages in the campus and community are changed, college officials face an uphill battle. Sources of mixed messages are abundant in college communities: liquor stores that fail to check for proof-of-age identification; local bars that offer "happy hours" and other low-price promotions or that serve intoxicated patrons; on-campus advertising for beer and other alcoholic beverages;(17) an absence of alcohol-free social and recreational options; faculty who make minimal demands on students and take little interest in their well-being; lax enforcement of campus regulations, local ordinances, or state and federal laws. College officials cannot expect students to say "no" to binge drinking and other drug use when their environment tells them "yes." ------------------------------------------------------------------------ Environmental Management: A Public Health Perspective The essence of the environmental management approach to alcohol and other drug prevention is for college officials, working in conjunction with the local community, to change the campus and community environment that contributes to AOD problems. Such change can be brought about through an integrated combination of programs, policies, and public education campaigns. Stated simply, traditional approaches to prevention have tacitly accepted the world as it is and then tried to teach students as individuals how to resist its temptations. In contrast, with the environmental management approach, there is a coordinated effort to change the world-- that is, the campus and community environment-- in order to produce a large-scale impact on the entire campus population, including students, faculty, staff, and administrators. The environmental management approach is intellectually grounded in the field of public health, which emphasizes the broader physical, social, cultural, and institutional forces that contribute to problems of human health.(18) The value of this perspective is evident in the story of Dr. John Snow, one of the fathers of the public health movement of the nineteenth century. In 1854, a cholera epidemic was sweeping across Europe. During one outbreak in London, over 500 people died in just ten days. No one knew what caused the disease, and there was no cure. Having a hunch about what the source of the disease might be, Snow walked through the City of London to document where each victim had lived. By this method, he discovered that the outbreak was largely restricted to an area within 250 yards of the Broad Street water pump. Snow arranged for the pump to be removed, and within three days, the epidemic ended.(19) The broader lesson that Snow teaches us is that often the best way to protect public health is to change the environment in which people live and work. And this is what the fundamental work of public health has been-- draining the swamps, providing clean water, building sanitation facilities, guaranteeing a safe food supply, cleaning the air. In developed countries attention eventually shifted to health problems such as cardiovascular disease, cancer, sexually transmitted disease, and unintentional injury that have behavioral antecedents. Recent years have seen the useful application of environmental approaches to address these problems as well. One example, the recent U.S. record in decreasing alcohol-related traffic fatalities, is remarkable. In 1982, there were 25,165 alcohol-related traffic fatalities, which represented about 57 percent of all fatal crashes, according to the National Highway Transportation Safety Administration (NHTSA). In 1995, alcohol was involved in 17,274 crash fatalities, which were 41 percent of that year's crash fatalities. Hence, between 1982 and 1995, the number of alcohol-related fatalities dropped by 31 percent, and the proportion of crash fatalities involving alcohol fell by 28 percent.(20) Why? Modern U.S. efforts to combat drunk driving began with the founding of grass-roots organizations such as Mothers Against Drunk Driving (MADD), Students Against Driving Drunk (SADD), and Remove Intoxicated Drivers (RID). Their first success was a widespread change in public attitudes. Emerging from this change in public attitudes came the passage of new laws that impose firm and consistent punishment against convicted drunk drivers with the hope of decreasing repeat offenses. Those efforts were followed by the implementation of general deterrence policies, such as sobriety checkpoints (police roadblocks), that are designed to increase public perceptions of the risk of apprehension and punishment. More recently, drunk driving prevention work has focused on alcohol control policies. One example is the age 21 drinking law, which has saved well over 15,000 lives since the mid-1980s, when all fifty states were required to raise the minimum drinking age.(21) Cigarette smoking in the United States has also dropped dramatically in recent years. Higher excise taxes on cigarettes appear to be among the most effective strategies for decreasing smoking by youth. One study estimated that a doubling of the federal excise tax on cigarettes in 1983 reduced the number of teenage smokers by 800,000. In Canada, where a combination of new federal and provincial taxes raised the average price of twenty cigarettes to over $4.22 (U.S.) by late 1993, there has been a dramatic decline in youth smoking. One study reported a 62 percent drop in the percentage of fifteen to nineteen year olds who reported daily (or regular) smoking.(22) Another effective means of preventing adolescents from smoking is to eliminate their access to tobacco products. With that in mind, the new U.S. Food and Drug Administration (FDA) regulations include provisions to limit vending machine sales and self-service displays to places where minors are not allowed, such as certain bars and nightclubs; limit sales to those customers who are eighteen or over and can show proof of age; prohibit the sale of single cigarettes and packages of less than twenty; and prohibit the offer of free cigarette samples.(23) Similarly motivated, the Synar Amendment to the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act (1993) requires states to enact and enforce a law prohibiting the sale or distribution of tobacco products to minors.(24) Other examples of environmental management for the sake of public health can be cited. Years of exhorting people to wear seat belts had little effect. Seat belt use has, however, increased dramatically in states that have passed mandatory seat belt laws and have used the mass media to remind the public that the laws are strictly enforced.(25) Recent advances in violence and other crime prevention have resulted from changes in community design to create "defensible space," provide for better property management, and alter or expand land use patterns.(26) They have also resulted from changes in police law enforcement strategies to crack down on minor nuisances and petty crimes that otherwise would signal that a neighborhood is an easy target for major criminal activity.(27) In sum, the chief lesson from work in public health is that people's behavior is shaped by their environment, so if we are to change their behavior, we need to change that environment. Environmental management represents a radical shift in thinking about prevention in higher education, a new doctrine for managing student conduct that requires college officials to view their role and responsibilities in a new way. ------------------------------------------------------------------------ Environmental Management: A Case Law Perspective The environmental management approach is also grounded in recent judicial case law. Recent court rulings have made clear that colleges are not expected to control student conduct, stating that it is both unrealistic and inappropriate to expect college administrators to control their students' private behavior. In effect, the courts have said that attendance at a college does not make a student any less an independent and free-acting adult. Such rulings have brought the era of in loco parentis to a close.(28) On the other hand, the courts have stated that colleges must take reasonable protective measures to guard against foreseeable hazards and risks in the school environment. In essence, then, colleges must ensure that their activities, offerings, and programs meet minimum standards of care, and they must take steps to deal with dangerous situations on campus. In one sense, these rulings mean that colleges and universities have the same responsibilities as other property owners.(29) As concern about alcohol-related injuries has increased, the courts have been increasingly sympathetic to plaintiffs who have sued third parties for damages caused by someone who had been drinking. Colleges or universities that sell alcohol face special risks. Furthermore, a college may be monetarily liable as a social host when administrators, faculty, or others who act as its agents provide alcoholic beverages.(30) Many college officials once hesitated to articulate clear alcohol and other drug policies on the assumption that these policies, because they could not be perfectly enforced, would contribute to the institution's liability in a court of law. School officials can no longer justify this stance. In addition to the court rulings, the Drug-Free Schools and Campuses Act now requires colleges to develop, announce, and enforce an unequivocal set of policies for preventing the misuse of alcohol and other drugs on campus.(31) In response to this changing legal climate, a college's prevention programs and policies should seek to establish and maintain an environment that will discourage student substance use. If effectively implemented and enforced, these measures will contribute to a safer environment, one that not only reduces the college's risk exposure but also enhances its ability to accomplish its educational mission. ------------------------------------------------------------------------ Spheres of Action for AOD Prevention Recent prevention work in public health has been guided by a social ecological framework that recognizes that health-related behavior is affected through multiple levels of influence: intrapersonal factors, interpersonal processes, institutional factors, community factors, and public policy.(32) As noted, the primary focus of AOD prevention efforts on most campuses has been intrapersonal factors and interpersonal processes. Activities focused on intrapersonal factors have been designed to increase awareness of AOD-related problems, change attitudes and beliefs, and foster a determination to avoid binge drinking and other drug use. Activities focused on interpersonal processes have been designed to use peer-to-peer communication to change student social norms about alcohol and other drug use. A focus on institutional factors, community factors, and public policy constitutes the doctrine of environmental management. There are five aspects of typical campus and community environments that should be the focus of environmental change efforts: 1. The majority of students have few adult responsibilities and a great deal of unstructured free time, especially at residential colleges. 2. Alcohol is abundantly available and inexpensive. 3. There are pervasive messages that binge drinking and other drug use are a normal part of the college experience. 4. There are too few social and recreational options for students. 5. Students who may be in trouble with alcohol or other drugs are not readily identified or referred to early intervention services. As suggested by the social ecological model, there are three spheres of action in which to work for environmental change to address these problems (see figure 1): the institution of higher education, the surrounding community, and state-level public policy. The remainder of this publication reviews each of these areas in turn. Programs and policies on campus (institutional factors) can be engaged by a campuswide task force. Community programs and local ordinances (community factors) can be the focus of a campus and community coalition. Finally, state-level public policy can be addressed through associations of higher education officials, especially college presidents. Figure 1. Three Spheres of Action [Three Spheres of Action] ------------------------------------------------------------------------ Addressing Institutional Factors The primary vehicle for creating environmental change on campus should be a campus-based AOD task force.(33) There are representatives from a broad spectrum of campus interests and constituencies who need to be part of the task force, as shown in figure 2. Students, alumni, parents, and various community representatives should also be part of the task force. The task force should report directly to the college president. Ideally, the work of the task force should be coordinated by the AOD prevention coordinator, who acts as a "change agent" on campus. Accordingly, that individual's skill base must go beyond education and program development to include political organizing, coalition building, and advocacy. At present, few AOD coordinators have these skills, but they are necessary if these individuals are to help maintain the college's focus on environmental change. The AOD task force shares responsibility with the college president for helping maintain alcohol and other drug prevention near the top of the college's agenda and for creating a climate of support for an environmentally focused approach to prevention. The task force can consider developing a social marketing campaign to create that climate or to promote specific programs and policies.(34) The task force will have several important duties. The first is needs assessment, which should include an assessment of the problem and a comprehensive review of existing AOD programs and policies.(35) More than that, however, the task force should explore the structure of the institution and the basic premises of the educational program to see how they affect alcohol and other drug use. New arrangements might help students become better integrated into the intellectual life of the school, change student norms away from alcohol and other drug use, or make it easier to identify students in trouble with substance use. Based on that assessment, the task force can craft a strategic plan for new programs and policies. Prevention begins with the admissions process. Questions to consider: Should the college's admissions criteria be altered so that newly matriculated students are at less risk of binge drinking and other drug use? Should the college be presented in its promotional literature and on campus tours in a way that attracts lower-risk students? What should the materials say regarding the college's expectations about student conduct? Regarding the academic program, should graduation requirements be made more rigorous? Are steps needed to hold grade inflation in check? Should students be expected to do a certain number of hours of volunteer work to reduce their free time and to give their educational experience additional meaning? Should class sizes, faculty advisor duties, and other aspects of the teaching role be changed to increase student contact with faculty? Does the academic calendar need to be changed to restrict opportunities for substance abuse?(36) Steps may also be needed to create new recreational and entertainment options as alternatives to fraternities and sororities. Does the college need to create the infrastructure to support these alternatives-- student centers, dormitory commons areas, athletics facilities, clubs and coffeehouses? Should fraternities and sororities be banned or otherwise restricted? Should school officials support the establishment of student "wellness" groups or other student organizations that will help move student norms away from binge drinking? Action may be required to limit alcohol availability and the circumstances of alcohol use. On many campuses where alcohol is permitted, responsible beverage service programs are a plus.(37) Given the profits that the alcohol industry makes from sales to underage and problem drinkers, and given the problems that alcohol misuse creates on college campuses, several school administrators have concluded that it is improper for their college to collaborate in the industry's marketing activities.(38) If school officials are unprepared to impose a total ban on campus advertising and promotion, they might consider developing strict policies to define what they will allow. The ultimate goal in addressing this wide range of issues is to promote alcohol and other drug prevention and to create a safer campus where learning can take place. Colleges are systems. Each component of the system plays a role in AOD use, and each has a potential role as part of a comprehensive prevention strategy focused on environmental change. A full discussion of program and policy options can be found in Setting and Improving Policies for Reducing Alcohol and Other Drug Problems on Campus: A Guide for Administrators.(39) Another task force responsibility is to continue monitoring campus conditions and to evaluate the college's prevention efforts. Under the Drug-Free Schools and Campuses Act, every institution of higher education must enact policies for preventing the unlawful possession, use, or distribution of alcohol and illicit drugs by students and employees. Failure to comply puts the school's federal funding, including student financial aid, at risk. The law also requires postsecondary schools to prepare a written review of their program every two years to determine its effectiveness and to ensure that the school's sanctions are being consistently enforced. The written biennial review must be made available to anyone who asks for a copy.(40) To develop effective programs and policies that can reduce AOD-related problems on campus, the task force needs to understand fully the nature and extent of these problems at their school. This understanding can be achieved only if the task force has credible data on patterns of student alcohol consumption and drinking-related risk behavior. The best way to obtain these data is to conduct an annual survey using a random selection of student respondents.(41) Other data collection systems can be employed, too, including a centralized data system for all alcohol-related violations of campus policies, student health data (reported in aggregate, with privacy safeguards), and environmental indicators of alcohol and other drug use. College President A key to the task force's success is presidential leadership. College presidents, working in conjunction with the board of trustees, should put alcohol and other drug prevention at the top of their higher education agenda. This means speaking out and writing about the issue to convey clear expectations and standards, as well as to build support for new programs and policies, especially those with an environmental focus. Presidential leadership also means reaching out to campus, community, and state-level groups to develop and implement a comprehensive strategy for prevention.(42) Faculty Faculty also play a critical role in helping create a campus environment that discourages AOD use.(43) Motivating faculty depends, in part, on conceptually linking academic reform, which faculty clearly view as their purview, with AOD prevention. In recent years, the primary way that prevention advocates have sought to involve faculty is through course development or curriculum infusion, whereby faculty weave prevention-oriented material into their regular courses. A marketing class, for example, might look at the relationship between alcohol advertising expenditures and patterns of use by middle school students. Or a psychology class might study the course of alcohol addiction. As members of the task force, or through the faculty senate, faculty can also exercise leadership in proposing new initiatives to change the campus climate on AOD use. Especially important in this context are academic reform issues: for example, classroom attendance requirements, financial support or recognition for high-achieving students, service learning requirements, the grading system (to reduce "grade inflation"), the academic calendar (to prevent weekends from starting on Thursday night), and the faculty advising role (to increase faculty-student contact). In addition, faculty can also carry out evaluations of these and other initiatives to help gauge their implementation and effectiveness. Because they are important voices in the college community, faculty should also speak out and write about prevention issues. Data collected by the Core Institute suggest that faculty are largely unaware that their own concerns about substance abuse are shared by the vast majority of other faculty.(44) The problem is self-perpetuating. Faculty hesitate to speak out, thinking that their opinions are not widely shared, which reinforces the misperception of faculty indifference. Faculty also need to be trained to identify and refer students who are in academic trouble and may be having substance use problems. Smaller classes, coupled with more extensive advising requirements, would facilitate this process while also making students feel more connected to the educational mission of the school, a known protective factor in AOD prevention. Early Intervention Services A comprehensive approach to prevention also requires improved early intervention services. Faculty and athletics coaches have a key role to play in identifying and referring students who may be in trouble with alcohol or other drugs. In addition, students who visit the student health clinic should routinely be asked about their drinking habits and other drug use, no matter what their reason for visiting, so that early intervention services can be recommended when needed. If students are found guilty of violating a campus rule, and if alcohol was a factor in their offense, they should be required to participate in alcohol education or treatment programs as part of the disciplinary process. Admissions Office There are significant steps that can be taken by other segments of the academic community, each of which will contribute to creating a prevention-oriented environment. The admissions department can use catalogs, the school's World Wide Web site, and other marketing tools to let applicants know about the college's approach to AOD prevention and to communicate clear standards of conduct. Similarly, the campus tour can be used to highlight the college's efforts to create extracurricular and recreational options to discourage an AOD-oriented student culture. It is also possible for the admissions criteria to be modified or to create special incentives to appeal to students who are at reduced risk for alcohol and other drug use.(45) Resident or Student Life Office The office of resident or student life can work to expand campus residential options to support changes in student social norms. One option is substance-free housing.(46) Another option is to revamp the college's dormitories to create places for faculty-student dinners, academic seminars, student dances, and coffeehouse events. Likewise, this office can work to create new recreation and entertainment options, such as a student center that houses a café and games arcades, while also providing a variety of alcohol-free activities, including dances, banquets, and public forums.(47) An investment can also be made to expand the range of extracurricular options available, including health and fitness or wellness clubs. The office of resident or student life can also install an ombudsman or campus committee to protect the rights of non-binge drinking and non-drug using students.(48) Campus Pub Managers of campus pubs and bars should install a responsible beverage service (RBS) program and then take the lead in working with local bar and restaurant owners to install similar programs in the community at large.(49) RBS programs have three goals: (1) to prevent alcohol service to minors, (2) to reduce the likelihood of drinkers becoming intoxicated, and (3) to prevent those who are alcohol-impaired from driving.(50) Successful programs share two important characteristics. First, when working with students, successful RBS programs embed the responsible host message within an overall program on how to have a more successful social event. Second, successful programs view RBS as a community issue, not as a campus issue. By working together, a town-gown coalition can help ensure that students receive a clear and consistent message about responsible alcohol consumption. Athletics Department Athletics directors have a special responsibility, not only because athletes are both highly visible and function as opinion leaders on campus but because of the documented greater risk for student athletes to be involved in alcohol, tobacco, and other drug use, including steroids.(51) From the standpoint of an environmental approach to prevention, it is essential that the college not establish a double standard that favors athletes over other students. Athletics directors can also take the lead in installing effective stadium and arena management policies to reduce alcohol-related problems, similar to what professional sports teams have done.(52) Campus Law Enforcement Whatever programs or policies are implemented, their impact will be undermined without strict and consistent enforcement of school regulations and local, state, and federal laws. A detailed examination of how rules against underage drinking are currently enforced reveals a widespread laxity that stands in contrast to the requirements of the Drug-Free Schools and Campuses Act.(53) School administrators and security officials are missing key opportunities for more effective action to enforce the minimum age drinking law. This lack of enforcement gives the wrong signal to students, while also putting the school at legal risk. There are five major actions that college officials can consider to strengthen their law enforcement efforts: 1. Impose and enforce a program of responsible beverage service that lays out the requirements that must be met before students are allowed to host a party at which alcohol is served. 2. Require that Greek houses meet building codes, health regulations, alcohol licensing requirements, and other state and local ordinances before students are allowed to host parties or other events. 3. Identify on-campus locations where underage drinking is occurring and then take meaningful disciplinary action against those who are serving alcohol to minors. 4. Establish a policy of "zero tolerance" for fake IDs that underage students use to purchase or be served alcohol. 5. Take firm disciplinary steps against students who drive or commit other infractions while under the influence, including probation, fines, community service, suspension, and expulsion. College administrators can build broad support for firm enforcement of the minimum age drinking law and other enforcement actions by using a problem-oriented strategy that holds students strictly accountable for assault, drunk driving, vandalism, and other infractions committed while under the influence of alcohol. To act as an effective general deterrent, these enforcement-oriented steps must be frequently publicized. It is also vital to publicize that disciplinary actions have been executed, with care taken to protect the privacy rights of the individual students involved. ------------------------------------------------------------------------ Figure 2. Campus Task Force Environmental Strategies [Campus Task Force] * admissions procedures * faculty advisor duties * presidents, trustees, * academic requirements deans, and campus * service learning programs attorneys * class scheduling * residential life options * faculty and teaching * extracurricular/recreational options assistants * alcohol availability * admissions officers and * responsible beverage service resident life directors * alcohol industry advertising/sponsorships * student leaders and activists Educational Strategies * AOD prevention * awareness and information campaigns coordinators * curriculum development and infusion * peer education * health care and * student leadership training counseling staff Early Intervention Strategies * police and campus security officials * student and employee assistance programs * athletics officials * counseling and support groups * Greek officers Enforcement Strategies * alumni and parents * targeted policing strategies * disciplinary procedures and * community leaders and sanctions local officials * campus judicial system ------------------------------------------------------------------------ Addressing Community Factors Whatever students are told on campus about alcohol, if the surrounding community delivers a dissimilar "educational message" through low-price beer promotions, illegal sales to minors, lax law enforcement, and low alcohol excise taxes, students will continue to experience significant alcohol-related problems.(54) The same concern applies to other drug use. If the community has weak prevention programs, lax law enforcement, and inadequate drug treatment resources, then students will be facing an environment that invites problems with illicit drugs.(55) In short, student binge drinking and illicit drug use are not problems of colleges alone, but of the entire community, and it will take the entire community to solve them. It is necessary, therefore, for campus and community officials to collaborate to rework the physical, social, legal, and economic environment that drives student alcohol and other drug use. As noted, the college's campus task force should include community representatives among its members, at a minimum the head of a local AOD prevention task force. In turn, local task forces should include college officials among their membership. In effect, then, campus and local task forces should have overlapping directorates. A chief focus of a campus and community coalition should be to curtail youth access to alcohol and to eliminate irresponsible alcohol sales and marketing practices by local bars, restaurants, and liquor outlets.(56) Key objectives for the coalition can include the following: (1) changes in local zoning ordinances to reduce the density of alcohol sales outlets and irresponsible sales and marketing practices; (2) a communitywide program for responsible beverage service; and (3) enhanced, publicized police enforcement of the age 21 and drunk driving laws (see figure 3). The wisdom of such an approach has been reinforced by new research demonstrating the potential power of community-based coalitions to eliminate mixed message environments that invite irresponsible alcohol use.(57) The investigators worked with three experimental communities, two in California and one in South Carolina, to organize citizen-led programs for more effective community control of alcohol focusing on the three objectives listed above. The responsible beverage service program centered around the development of alcohol service policies by bars and restaurants, coupled with training of alcohol beverage servers. Clerks at alcohol sales outlets also received training in how to check for legal proof of age. Enforcement of the age 21 law was enhanced through police officer training and increased budget allocations. Police also conducted monthly sobriety checkpoints to apprehend drunk drivers and used passive alcohol sensors during routine traffic stops. In the program communities, relative to three comparison communities, alcohol sales to minors were cut by half, and there was a 10 percent reduction in nighttime traffic crashes involving a single vehicle (a surrogate measure for alcohol-related crashes). Community mobilization, involving a mix of civic, religious, and governmental agencies, is widely recognized as a key to successful prevention.(58) Essential to making community-based programming work is the formation of coalitions and interagency linkages that lead to a coordinated approach, with adequate planning and a clear division of responsibilities among coalition members. Where such programs are lacking, higher education officials can take the lead in forming these citizen-led coalitions and moving them toward an environmental approach to prevention. A coalition can also be the vehicle for greater coordination between campus and community agencies. One example was cited previously, the formation of a responsible beverage service task force that includes both campus- and community-based representatives. Similarly, coordination between campus and local police is vital to ensure that crimes are reported, properly investigated, and referred for criminal prosecution. Campus and local police can also engage in joint enforcement strategies, including "decoy" operations, targeted patrols, and sobriety checkpoints.(59) Finally, coordination between student health services and local hospitals is also essential if students who need follow-up referral and treatment are to be identified. ------------------------------------------------------------------------ Figure 3. Campus and Community Coalition Environmental Strategies * community business [Campus and Community Coalition] development * zoning ordinances * permit and licensing * elected officials restrictions * advertising * other government officials restrictions * responsible beverage * college officials service * law enforcement officials Educational Strategies * liquor store owners * awareness and information campaigns * college students * media advocacy * social marketing * parents * leadership training * AOD treatment providers Early Intervention Strategies * community development officials * counseling and support * AOD prevention leaders groups * Alcoholic Beverage Control (ABC) Enforcement Strategies officials * "sting" operations * restaurant and bar owners * sobriety checkpoints * "killer bar" patrols * ID checks * criminal prosecution ------------------------------------------------------------------------ Addressing Public Policy As part of a total effort to create environmental change, college officials should also consider working for policy change, especially at the state level. New laws and regulations will affect the community as a whole and can help change social norms, thereby affecting student alcohol and other drug use. As noted earlier, the value of this approach in AOD prevention was demonstrated by age 21 laws. When President Reagan signed the National Minimum Age Drinking Act of 1984, the states were required to raise their minimum legal drinking age to twenty-one. Any state that failed to comply by 1986 risked the withholding of federal highway funds. All fifty states complied, resulting in well over 15,000 lives saved since 1975.(60) Examples of potentially helpful laws and regulations include the following: 1. Imposing lower blood alcohol limits for drivers under age 21, usually 0.02 percent BAC (blood alcohol concentration)(61) 2. Using distinctive and tamper-proof licenses for drivers under age 21 3. Passing "use and lose" laws that impose driver's license penalties on minors who purchase or are found in possession of alcohol 4. Increasing penalties for illegal service to minors 5. Requiring responsible beverage service training and certification for commercial alcohol servers 6. Passing dram shop laws that make serving an intoxicated drinker or a minor a cause for legal action 7. Prohibiting "happy hours" and other reduced-price alcohol promotions 8. Requiring registration of purchasers of kegs and other large common sources of alcohol 9. Strengthening laws concerning hours of sale, characteristics and density of retail outlets, and other factors that affect alcohol availability 10. Funding strong enforcement programs by the alcohol beverage control commission and local police, including the use of decoys in "sting" operations 11. Increasing excise tax rates on beer and wine to the same level (by alcohol content) as for distilled spirits, and linking future increases to the rate of inflation(62) It is useful for individual college officials, especially presidents and trustees, to speak out on these and other proposals, which could potentially serve to help institutions of higher education do a better job of ensuring campus safety and of maintaining an academic environment conducive to their students' intellectual and social development. Faculty can do the same, either as advocates or as researchers who can provide expert testimony in support of proposed laws and regulations. Acknowledging that substance abuse is a problem that their schools have in common, presidents and other college officials should participate in state, regional, and national associations to present an academic viewpoint on various policy proposals. College officials cannot take these steps on behalf of their institution, of course. Despite that, they still retain the rights of any private citizen to speak out and should be encouraged to do so. ------------------------------------------------------------------------ Conclusion The conceptual framework presented here is designed to help college officials understand the wisdom of broadening their approach beyond awareness education, peer education, curriculum infusion, and other traditional prevention programs to include a range of strategies that will change the campus and community environment in which students are making decisions about drinking and other drug use. Implementation of effective environmental strategies will only come about if there is strong presidential leadership on the issue of alcohol and other drug prevention; a campuswide task force that includes a broad spectrum of faculty, staff, and students; engagement with the community through a campus and community coalition; and the active participation of college officials in public policy debates, especially at the state level. An important foundation for any campus prevention effort is the establishment and enforcement of sound prevention-oriented policies. If a participatory process is used to develop such policies, they can gain widespread support from faculty, staff, trustees, alumni, students, and parents. Ultimately, those policies will help create a campus environment that serves to enhance each student's capacity for learning. The last few years have taught AOD prevention experts that the fight against AOD use cannot be put on "automatic pilot" or simply relegated to the schools alone. To ensure that students receive a consistent message about alcohol and other drugs, the entire community must remain vigilant, active, and focused. Prevention experts know what to do. The difficulty is motivating people to do the hard work required and then to continue that effort over time, even when AOD usage trends become favorable. A very dangerous time is when policymakers or the public begin to think that the problem is solved and the public agenda turns elsewhere. ------------------------------------------------------------------------ Notes 1 Carnegie Foundation for the Advancement of Teaching. Campus Life: In Search of Community (Princeton, NJ: Carnegie Foundation for the Advancement of Teaching, [1990] 1994). 2 Wechsler, H.; Davenport, A.; Dowdall, G.; Moeykens, B.; and Castillo, S. ěHealth and Behavioral Consequences of Binge Drinking in College: A National Survey of Students at 140 Campuses," Journal of the American Medical Association 272 (1994): 1672-77. 3 Wechsler, H.; Dowdall, G.; Davenport, A.; and Rimm, E. B. ěA Gender-Specific Measure of Binge Drinking Among College Students," American Journal of Public Health 85 (1995): 982-85. 4 Presley, C. A.; Meilman, P. W.; and Cashin, J. R. Alcohol and Drugs on American College Campuses: Use, Consequences, and Perceptions of the Campus Environment. Vol. IV: 1992-94 (Carbondale, IL: Core Institute, Southern Illinois University, 1996). 5 Wechsler, H.; Moeykens, B.; Davenport, A.; Castillo, S.; and Hansen, J. ěThe Adverse Impact of Heavy Episodic Drinkers on Other College Students," Journal of Studies on Alcohol 56 (1995): 628-34. 6 Johnston, L. D. "The Epidemiology of Marijuana and Other Illicit Drugs," in Secretary's Youth Substance Abuse Prevention Initiative: Resource Papers (Rockville, MD: U.S. Department of Health and Human Services, Center for Substance Abuse Prevention, 1997). 7 Presley; Meilman; and Cashin, op. cit. 8 DeJong, W., and Langenbahn, S. Setting and Improving Policies for Reducing Alcohol and Other Drug Problems on Campus: A Guide for Administrators (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, [1995] 1997). 9 Wallack, L., and DeJong, W. "Mass Media and Public Health: Moving the Focus of Change from the Individual to the Environment," in The Effects of the Mass Media on the Use and Abuse of Alcohol (Rockville, MD: U.S. Department of Health and Human Services, National Institute on Alcohol Abuse and Alcoholism, 1995), 253-68. 10 Ryan, B. E., and DeJong, W. Making the Link: Faculty and Prevention (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1998). 11 Perry, C. L.; Williams, C. L.; Veblen-Mortenson, S. et al. "Project Northland: Outcomes of a Communitywide Alcohol Use Prevention Program During Early Adolescence," American Journal of Public Health 86 (1996): 956-65. 12 Zimmerman, R. Social Marketing Strategies for Campus Prevention of Alcohol and Other Drug Problems (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1997). 13 Perkins, H. W., and Wechsler, H. "Variation in Perceived College Drinking Norms and Its Impact on Alcohol Abuse: A Nationwide Study," Journal of Drug Issues 26 (1996): 961-74. 14 Haines, M., and Spear, A. F. "Changing the Perception of the Norm: A Strategy to Decrease Binge Drinking Among College Students," Journal of American College Health 45 (1996): 134-40. 15 DeJong, W. Preventing Alcohol-Related Problems on Campus: Impaired Driving (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1995). 16 DeJong and Langenbahn, op. cit. 17 Erenberg, D. F., and Hacker, G. A. Last Call for High-Risk Bar Promotions That Target College Students: A Community Action Guide (Washington, DC: Center for Science in the Public Interest, 1997). 18 Wallack, L.; Dorfman, L.; Jernigan, D.; and Themba, M. Media Advocacy and Public Health: Power for Prevention (Newbury Park, CA: Sage Publications, 1993). 19 DeJong, W., and Winsten, J. A. The Media and the Message: Lessons Learned from Past Public Service Campaigns (Washington, DC: The National Campaign to Prevent Teen Pregnancy, 1998). 20 National Highway Traffic Safety Administration (NHTSA). Traffic Safety Facts 1995: A Compilation of Motor Vehicle Crash Data from the Fatal Accident Reporting System and the General Estimates System (DOT HS 808 471) (Washington, DC: U.S. Department of Transportation, 1996). 21 DeJong, W., and Hingson, R. "Approaches to the Reduction of Driving Under the Influence of Alcohol," Annual Review of Public Health (Vol. 19) (Palo Alto, CA: Annual Reviews, 1998), 359-78. 22 Lynch, B. S., and Bonnie, E. J. (eds.). Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youth (Washington, DC: National Academy Press, 1994). 23 Kessler, D. A.; Witt, A. M.; Barnett, P. S. et al. "The Food and Drug Administration's Regulation of Tobacco Products," New England Journal of Medicine 335 (1996): 988-94. 24 Lynch and Bonnie, op. cit. 25 Nelson, D. E.; Bolen, J.; and Kresnow, M. "Trends in Safety Belt Use by Demographics and by Type of State Safety Belt Law, 1987 through 1993," American Journal of Public Health 88 (1998): 245-49. 26 Feins, J. D.; Epstein, J. C.; and Widom, R. Solving Crime Problems in Residential Neighborhoods: Comprehensive Changes in Design, Management, and Use (Washington, DC: U.S. Department of Justice, National Institute of Justice, 1997). 27 Wilson, J. Q., and Kelling, G. L. "Broken Windows: The Police and Neighborhood Safety," The Atlantic Monthly (March 1982). 28 Gehring, D. D., and Geraci, C. P. Alcohol on Campus: A Compendium of the Law and a Guide to Campus Policy (Asheville, NC: College Administration Publications, 1989). 29 DeJong and Langenbahn, op. cit. 30 American Council on Education. Institutional Liability for Alcohol Consumption: A White Paper on Institutional Liability for Consumption of Alcohol and Drugs on Campus (Washington, DC: American Council on Education, 1992). 31 Pittayathikhun, T.; Ku, R.; Rigby, D.; Mattsson, M.; and DeJong, W. Complying with the Drug-Free Schools and Campuses Regulations [34 CFR Part 86]: A Guide for University and College Administrators (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1997). 32 Stokols, D. "Translating Social Ecological Theory into Guidelines for Community Health Promotion," American Journal of Health Promotion 10 (1996): 282-98. 33 DeJong and Langenbahn, op. cit. 34 Zimmerman, op. cit. 35 Ryan, B. E.; Colthurst, T.; and Segars, L. College Alcohol Risk Assessment Guide: Environmental Approaches to Prevention (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, [1994] 1997). 36 Ryan and DeJong, op. cit. 37 Mosher, J. F. Responsible Beverage Service: An Implementation Handbook for Communities (Palo Alto, CA: Health Promotion Resource Center, Stanford University, 1991). 38 Ryan, B. E., and Mosher, J. F. Progress Report: Alcohol Promotion on Campus (San Rafael, CA: Marin Institute for the Prevention of Alcohol and Other Drug Problems, 1991). 39 DeJong and Langenbahn, op. cit. 40 Pittayathikhun; Ku; Rigby; Mattsson; and DeJong, op. cit. 41 DeJong, W., and Wechsler, H. Preventing Alcohol-Related Problems on Campus: Methods for Assessing Student Use of Alcohol and Other Drugs (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1996). 42 Presidents Leadership Group. Be Vocal, Be Visible, Be Visionary: Recommendations for College and University Presidents on Alcohol and Other Drug Prevention (Newton, MA: Higher Education Center for Alcohol and Other Drug Prevention/EDC, 1997). 43 Ryan and DeJong, op. cit. 44 Ibid. 45 Goree, C. T., and Szalay, L. B. Rethinking the Campus Environment: A Guide for Substance Abuse Prevention (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1996). 46 Finn, P. Preventing Alcohol-Related Problems on Campus: Substance-Free Residence Halls (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1996). 47 DeJong, W. "Party School Takes On Student Binge Drinking," Prevention File: Alcohol, Tobacco, and Other Drugs (Spring 1997): 2-6. 48 Wechsler, H.; Moeykens, B. A.; and DeJong, W. Enforcing the Minimum Age Drinking Law: A Survey of College Administrators and Security Chiefs (Washington, DC: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1995). 49 DeJong, Preventing Alcohol-Related Problems on Campus: Impaired Driving. 50 Mosher, op. cit. 51 Wechsler, H.; Dowdall, G. W.; Davenport A.; and Castillo, S. "Correlates of College Student Binge Drinking," American Journal of Public Health 85 (1995): 921-26. 52 DeJong, Preventing Alcohol-Related Problems on Campus: Impaired Driving. 53 Wechsler; Moeykens; and DeJong, op. cit. 54 Stewart, K. "Environmentally Oriented Alcohol Prevention Policies for Young Adults," in Secretary's Youth Substance Abuse Prevention Initiative: Resource Papers (Rockville, MD: U.S. Department of Health and Human Services, Center for Substance Abuse Prevention, 1997). 55 Pentz, M. A. "Local Government and Community Organization," in Handbook on Drug Abuse Prevention: A Comprehensive Strategy to Prevent the Abuse of Alcohol and Other Drugs, ed. by R. H. Coombs and D. Ziedonis (Boston, MA: Allyn and Bacon, 1995). 56 Erenberg and Hacker, op. cit. 57 Holder, H. D.; Saltz, R. F.; Grube, J. W.; Voas, R. B.; Gruenewald, P. J.; and Treno, A. J. "A Community Prevention Trial to Reduce Alcohol-Involved Accidental Injury and Death: Overview," Addiction 92 (1997) (Supp. 2): 155-72. 58 Walter, C. L. "Community Building Practice: A Conceptual Framework," in Community Organizing and Community Building for Health, ed. by M. Minkler (New Brunswick, NJ: Rutgers University Press, 1997), 68-83. 59 DeJong, Preventing Alcohol-Related Problems on Campus: Impaired Driving. 60 DeJong and Hingson, op. cit. 61 Hingson, R.; Heeren, T.; and Winter, M. "Lower Legal Blood Alcohol Limits for Young Drivers," Public Health Reports 109 (1994): 739-44. 62 Saffer, H., and Grossman, M. "Beer Taxes, the Legal Drinking Age, and Youth Motor Vehicle Fatalities," Journal of Legal Studies 16 (1987): 351-74. ------------------------------------------------------------------------ Other publications are available from the Center. Visit http://www.edc.org/hec/ to download copies of most of our publications or to place an order for print versions. ------------------------------------------------------------------------ [HEC Home]Higher Ed Center -|- About Us -|- Feedback -|- Shortcuts: