Spring 2009 SPECIAL EDITION: Prevention in Higher Education Alcohol, Tobacco and Other Drugs Prevention File Contents 2 SOCIAL NORMS MARKETING CAMPAIGNS ON CAMPUS: WHAT THE RESEARCH SHOWS By William DeJong Social norms marketing campaigns to correct misperceptions of drinking norms are a popular prevention program on many campuses, but do they work? 7 Q & A WITH FRAN HARDING The new director of the U.S. Center for Substance Abuse Prevention talks about interagency collaboration and prevention research. 9 HOW OLD SHOULD YOU BE -- TO BUY ALCOHOL?? Despite research evidence on the effectiveness of age 21 drinking laws, some are calling for change. 13 TAXES AND HEALTH AND SAFETY Increasing interest in raising alcohol excise taxes. 16 BE PREPARED! Every year colleges and universities are called upon to respond to a wide variety of emergency and crisis situations. 20 BOOK REVIEW College Drinking: Reframing a Social Problem By George W. Dowdall A new book examines the broader cultural, organizational and social forces shaping drinking by college students. UPDATES Inside front and back covers. Prevention File is a publication of the Silver Gate Group (Federal Tax ID: 33- 0714724) Opinions expressed herein are those of the authors or other sources cited and do not necessarily reflect the beliefs of the Silver Gate Group, its editorial advisors, its officers or its personnel. Publisher: Tom Colthurst Editor: Barbara E. Ryan Editor Emeritus: Robert Zimmerman Contributing Editors: William DeJong, Jean Seager Design/Illustrations: John Lane Production: J. Lane Designs Copyright 2009 by the Silver Gate Group. Permission to reprint articles is granted for noncommercial use and with acknowledgment. We would appreciate receipt of any publication carrying a reprinted Prevention File article. Comments and suggestions are welcome. Address letters to Prevention File, Silver Gate Group P.O. Box 420878, San Diego, CA 92142-0878 Internet: tomc@silvergategroup.com http://silvergategroup.com Updates Prevention File Not So Sexy According to a recent study women appear, erroneously, to believe that men find excessive drinking sexually attractive and appealing. It found that 71 percent of women surveyed at two universities over estimated the men's actual preference of drinks at any given event. The women overestimated by an average of one-and- a-half drinks. When the researchers looked at the different subgroups, 26 percent of women said that men would most likely want to be friends with a woman who drinks five or more drinks and 16 percent said that men would be most sexually attracted to a woman who drank that much alcohol. Both estimates were nearly double what the men actually preferred. They also found the women who over estimated the men's preferences were more likely to engage in excessive drinking ("What men want: The role of reflective opposite-sex normative preferences in alcohol use among college women". Psychology of Addictive Behaviors, Vol. 23, No. 1, 2009). "Although traditionally, men drink more than women, research has shown that women have steadily been drinking more and more over the last several decades," said the study's lead author, Joseph LaBrie, PhD, associate professor of psychology at Loyola Marymount University. "There is a great, and risky, disconnect here between the sexes. While not all women may be drinking simply to get a guy's attention, this may help explain why more women are drinking at dangerous levels. We believe universities and other public health organizations could use this information to help curb binge drinking among young women." More Time Drinking than Studying? According to a survey of over 30,000 students who participated in a Fall 2008 online survey at AlcoholEdu for College, first-year college students who used alcohol drank an estimated 10.2 hours per week, compared to studying only 8.4 hours per week. Students who drank represented 68.9 percent of the respondents. Of these, 49.4 percent spent more time drinking alcohol than they did studying. The estimate of how much time first-year students spent studying was derived from several sources, including the Higher Education Research Institute's annual survey report, The American Freshman. "As student affairs professionals, we view the issue of college drinking as one of the biggest threats to our effectiveness as educators. Our hope is that this new finding will motivate all those within the academy, and even the larger community, to join us as we redouble our efforts to de-emphasize the role of alcohol in college life. Indeed, while comprehensive prevention programming has always been an imperative, it is clearly now more important than ever," Gwendolyn Jordan Dungy, PhD, executive director of the National Association of Student Personnel Administrators, told Science Daily (Mar. 11, 2009). The study, which was conducted by researchers at Outside The Classroom, was presented at the 2009 NASPA Strategies Conference: Alcohol Abuse Prevention & Intervention, held January 22-24 in Boston. Alcohol in the Media and Drinking Behavior Whether portrayals of drinking and alcohol advertising in movies or on television impact drinking behavior has long been the subject of debate among researchers and alcohol control advocates and the alcohol industry. Now a new Dutch and Canadian study of male university student's drinking behavior while watching an hour of TV (a movie clip with ad breaks) found that, compared to those who did not see much alcohol portrayed on screen, those who saw alcohol portrayed frequently, on average consumed 1.5 more 200 ml bottles of alcoholic beverage ("Alcohol portrayal on television affects actual drinking behaviour," Alcohol and Alcoholism, March 4, 2009). Lead author of the report Rutger Engels, professor of developmental psychopathology at the Behavioural Science Institute, Radboud University Nijmegen, The Netherlands, said: "This is the first experimental study to show a direct effect of exposure to alcohol portrayals on TV on viewers? immediate drinking behaviour." Engels said the study clearly showed that portraying alcohol in films and advertisements not only influenced people's attitudes about drinking within a culture or society, but might also have a direct effect on behavior, such as triggering a craving in people who already consume alcohol. The researchers said if their findings are replicated in other studies this should be a wake up call for policymakers. "If moderation of alcohol consumption in certain groups is strived for, it may be sensible to cut down on the portrayal of alcohol in programmes aimed at these groups and the commercials shown in between." Smart Drug Danger A recent small study has found that a so-called smart drug used as an illegal study aid by college students may carry more of an addiction risk than thought. Scans of ten healthy men showed that the prescription drug Provigil caused changes in the brain's pleasure center, very much like potentially habit-forming classic stimulants. "It would be wonderful if one could take a drug and be smarter, faster or have more energy," Nora Volkow, MD, director of the National Institute on Drug Abuse, who led the study with a Brookhaven National Laboratory scientist, said in an Associated Press dispatch. "But that is like fairy tales. We currently have nothing that has those benefits without side effects." According to AP, Modafinil's reputation as a brain enhancer stems from an Air Force study that found it improved the performance of sleep-deprived fighter pilots. Good Neighbor Policy The University of Wisconsin Board of Regents is considering a proposal to extend the disciplinary reach of state universities beyond campus grounds in response to complaints from residents in areas near campuses. Under the current code, university officials can discipline students for on-campus misconduct, but the code is less than clear about offcampus behavior. The university can punish students who commit assaults and damage property off campus if the victims are other university students or employees, but the code does not specify what the university can do in other cases. The last major revision of rules regarding non-academic disciplinary action occurred in 1996. The new policy would allow university officials to discipline students for off- campus actions if they fit into one of 16 specific categories and affect a substantial university interest. The 16 categories of behavior in the new policy range from sexual assault or property damage to "serious or repeated violations of municipal law." A student is subject to discipline, up to suspension or expulsion, if his or her off-campus behavior fits into one of these categories. The proposed changes came out of a committee convened in February 2007 by the Board of Regents. The revised rules are expected to take effect Fall 2009, after Board of Regents and state legislative review. California Campuses Welcome Vets! The Post-9/11 Veterans Educational Assistance Act, passed into law in 2008, takes effect on Aug. 1, 2009. A veteran enrolled as a full-time student taking 12 units is eligible to receive assistance in college tuition and fees, a book stipend and monthly housing allowance. Campuses throughout the country are expecting more students from the more than 1.6 million Americans who have served in Iraq and Afghanistan. In California alone, about 28,000 men and women a year muster out of active-duty service. According to the Los Angeles Times (Mar.4, 2009) San Diego State University, which is located in the nation's largest military community, is one campus that is determined to make the campus a leader in attracting veterans and supporting their educational endeavors. A veterans center has been established and fundraising continues for scholarships (Wal-Mart contributed $100,000). There is talk of creating military only housing along fraternity row. Vietnam veteran Jim Kitchen, now vice president for student affairs at SDSU, told the Times that he remembers his alienation when he returned to college in the Midwest after serving in the Army. "I was very bitter," Kitchen said. "We're not going to let that happen to these veterans." Other campuses in the California State University system are also involved under the governor's Troops to College program, which was established in 2006. In an agreement between California State University officials and the military, each year a total of 115 military personnel, selected by generals and admirals, will be guaranteed admission to one of the system's campuses. Other veterans will have their applications evaluated separately from civilian applicants. Social Norms Marketing Campaigns on Campus: What Research Shows by William DeJong For decades American students have been indoctrinated to believe that heavy drinking is a natural part of the college experience. Alcohol advertising, films, television programs, news stories, college lore-cultural messages from these many sources have contributed to the widespread belief that students who don't drink won't fit in. The unfortunate result is that college students think there is much more drinking going on than is actually the case. That misperception has significant consequences, for the choices students make about alcohol use are strongly influenced by what they think other students are doing, whether those impressions are accurate or not. Social norms marketing (SNM) campaigns are designed to correct misperceptions of campus drinking norms, the idea being that students will be inspired to drink less if they know what the true drinking norms are. Michael Haines at Northern Illinois University implemented the first SNM campaign, and annual surveys showing decreases in student drinking suggested that it might be working. Other colleges-the University of Arizona, Western Washington University, and Hobart and William Smith Colleges-soon touted similar findings. None of these early studies included survey data from control group institutions that did not have a SNM campaign. Even so, the case studies told a compelling story: four campuses that had struggled for years to drive down student alcohol use were now reporting a measure of success. Dozens of campuses soon began to experiment with this approach-some successfully, but some not. Clearly, there was a need for better research on social norms marketing. To meet this need, Laura Gomberg Towvim, Shari Kessel Schneider, and I launched the Social Norms Marketing Research Project (SNMRP) in 2000. Conducting this study took several years. Meanwhile, in 2002 and again in a 2007 update, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Task Force on College Drinking classified this approach as a Tier 3 strategy-meaning that it was "one of a number of popular strategies and policy suggestions make sense intuitively or have strong theoretical support." (A Call to Action: Changing the Culture of Drinking at U.S. Colleges, NIAAA, 2002) The 2007 NIAAA update characterized SNM as "still promising, but results are mixed and questions remain" (What Colleges Need to Know Now: An Update on College Drinking Research, NIAAA, 2007). There were both logical and theoretical reasons for thinking that SNM campaigns might work, but the absence of rigorous evaluations involving control groups left the matter in doubt. Social Norms Marketing Research Project Beginning in 2000, my colleagues and I conducted two randomized trials to test whether SNM campaigns can reduce student drinking levels. In both studies, we randomly assigned half of the participating colleges to a treatment group, which conducted a three-year campaign. The remaining half constituted a non- intervention control group. All of the alcohol and other drug coordinators certified that their campus had never mounted a SNM campaign. __________________________ Sidebar: National Social Norms Institute at the University of Virginia The NSNI's mission is to facilitate the use of social norms approaches to address a wide range of social behaviors, including high-risk alcohol consumption, smoking, drug use, risky sexual behavior, sexual violence, gambling, tax compliance, and energy conservation. The Institute hosts an annual National Conference on the Social Norms Approach, supports dissertation research, compiles research abstracts, and disseminates case study reports. For more information, go to the NSNI's website: http://www.socialnorms.org __________________________ The first study, involving 18 institutions, showed that the SNM campaigns had been effective. Across several survey measures, we saw that the level of drinking at the control group schools went up significantly, matching national trends reported by the Core Institute, while the intervention group schools showed no such increase. To our surprise, the second study, involving 14 institutions, showed no differences between the intervention and control group schools. Richard Scribner and his colleagues at Louisiana State University helped us sort out what had happened. To begin, for each of the 32 sites, we calculated the density of on-premise alcohol outlets (bars, taverns, restaurants) within a three-mile radius of campus. Next, we compared how well the SNM campaigns did when the density was at or above the median (10.78 outlets per 1,000 students) versus below the median. We found that the SNM campaigns did make a difference at institutions located in communities with low outlet density, but failed to have an effect in communities with high density, just as Scribner had long ago predicted. This finding explained the differing results for our two SNMRP studies. In the first, which showed that SNM campaigns can be effective, 13 of the 18 institutions were located in low-density communities. In the second study, a replication failure, 11 of the 14 institutions were located in high-density communities. Why might SNM campaigns be less effective when there are several outlets near campus? One possibility is that high outlet density reduces student misperceptions of drinking norms. Having more alcohol outlets promotes drinking, but these outlets, by encouraging public drinking, might also give students more opportunities to observe and accurately perceive elevated student drinking levels in that campus community. If most students tend not to misperceive the norms, what could a SNM campaign be expected to achieve? If this is the explanation, then campus officials working in such a community would want to address the alcohol environment prior to launching a social norms marketing campaign. This could be done through environmental management strategies that reduce the number of outlets near campus, restrict alcohol marketing and promotion, and limit the times, places, and circumstances under which alcohol can be purchased and consumed, all measures supported by the NIAAA Task Force on College Drinking. Another possible explanation for the SNMRP results is that the alcohol outlets- by their mere presence, but also because of their promotional advertising- communicate messages that compete with the SNM campaign and reinforce student misperceptions of campus drinking norms. Consistent with this perspective, Tom Workman from the University of Houston- Downtown has suggested that SNM campaigns might be less effective anytime the student body puts a high cultural value on excessive alcohol use, which could be signaled by a large number of alcohol outlets. If this is the case, Workman explains, then before launching a campaign, practitioners should conduct a readiness assessment to see whether a campus community is ripe for a SNM campaign. It's important to note, however, that the SNMRP studies provided each campus with start-up funds of only $2,000 per year, with supplemental funds of $300 to $1,650 per campus awarded for the second and third years. It's entirely possible that we did not provide the colleges facing high alcohol outlet density with sufficient resources to mount an effective campaign. University of Virginia Evaluation A later study conducted at the University of Virginia by James Turner, Wes Perkins, and Jennifer Bauerle supports the thesis that a large, highly visible SNM campaign can counteract an entrenched drinking culture and reduce alcohol- related problems. The university's SNM campaign began in 1999 with a focus on first-year students and then expanded in 2002 to include all undergraduates. The campaign messages corrected misperceptions about the quantity and frequency of alcohol use, while also communicating that most students practiced protective behaviors such as asking friends to slow down if they are drinking excessively, tending to a friend who had passed out, not allowing an intoxicated friend to drive, and using a designated driver or alternative transportation. The campaign grew over time. In 1999, staff introduced the campaign through a monthly series of posters. In 2002, the campuswide campaign was introduced, with weekly campus posters, newspaper ads and articles, and emails, plus staff and peer presentations in residence halls, Greek residences, and classrooms. In 2003, the staff organized small group sessions for fraternity and sorority members and athletes. In 2004, the campaign began to host an annual music event. Facebook ads commenced in 2005. Parent orientation sessions started before the 2002-03 academic year. The study did not include any control group institutions. Nonetheless, the University of Virginia study has two strengths. First, survey data were collected annually from 2001 through 2006. Second, no new policies or programs to address student drinking were launched at the institutional, community, or state level during this time. This convenient fact increases the likelihood that any observed changes were due to the SNM campaign and not to other initiatives. That noted, alternative explanations-such as changes in the student body having nothing to do with the campaign-cannot be completely ruled out. The changes in student behavior reported over the course of this intensive SNM campaign were dramatic. According to annual survey data, in 2001 only 33 percent of undergraduates reported experiencing none of ten negative consequences due to alcohol use, compared to 51 percent in 2006, and while 44 percent experienced multiple negative consequences in 2001, only 26 percent did so in 2006. Nationally, alcohol-impaired driving is the primary cause of alcohol-related student deaths. In 2001, 27 percent of University of Virginia undergraduates said they had driven under the influence of alcohol, but in 2006 only 15 percent indicated this was the case. As Turner and his colleagues point out, national surveys of college students showed no decrease or even slight increases in several self-reported negative consequences between 2001 and 2005. The University of Virginia's experience stands in stark contrast. Conclusion In my view, it is clear from recent research that social norms marketing campaigns should be part of any comprehensive effort to reduce college student drinking. The Social Norms Marketing Research Project showed that SNM campaigns are effective when the campus community has relatively low alcohol outlet density, but perhaps less so when the campus community has relatively high alcohol outlet density. The University of Virginia study suggests, however, that such campus communities may simply require more intensive campaigns. But that is not the whole story. Prior to its SNM campaign, the University launched several initiatives to change the environment in which students made decisions about their drinking, including: bolstering enforcement of alcohol rules, implementing parental notification, deferring Greek rush, eliminating celebratory drinking events, and training restaurant and bar servers. Turner and his colleagues report that these measures by themselves did not make a dent in the University's student drinking problem. It remains an open question, however, whether it was the SNM campaign by itself, or the campaign in combination with these environmental change efforts, that made the difference later on. Learning the answer to that question will require another randomized trial. William DeJong, PhD, is a professor of social and behavioral sciences at the Boston University School of Public Health and a senior advisor to the Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention. The Social Norms Marketing Research Project was funded by a grant from the National Institute on Alcohol Abuse and Alcoholism and the U.S. Department of Education (R01 AA 12471). _________________________ Sidebar: Guidelines for Future Social Norms Marketing Campaigns As new research continues to be done, proponents of social norms marketing have offered basic guidelines to direct future campaigns. Especially important is for the campaign to have a high level of activity. Occasional messages won't get the job done. The University of Virginia campaign is a good model to follow. Not all students are exposed to the same communication channels. As a result, reaching the broadest cross-section of students requires using multiple venues. Special consideration needs to be given to commuter students, who tend to be less engaged with campus life and therefore view student newspapers or other traditional student media less frequently. Intercept interviews can be used to identify how students learn about campus life. Once the SNM campaign is underway, Intercept interviews are a quick and easy way to gauge if and where students are seeing the campaign's messages. The results can be used to adjust the marketing strategy, either by altering the media venues being used or increasing overall activity levels. Future research should examine the impact of alternative campaign designs. For example, a continuing debate in the field is whether SNM campaigns should be focused on a single normative message or on multiple, mutually supportive messages. In the Social Norms Marketing Research Project study, the institutions that achieved positive results did so while using only a single message. Other SNM campaigns have successfully embedded alcohol-focused normative messages within a broader campaign focused on a wide range of student attitudes and behaviors. An experimental test is warranted to compare campaigns with multiple versus single messages. _________________________ Editor's note: For additional information on A Call to Action: Changing the Culture of Drinking at U.S. Colleges (NIAAA, 2002) go to http:// www.collegedrinkingprevention.gov/ NIAAACollegeMaterials/TaskForce/TaskForce_TOC.aspx. For more information on What Colleges Need to Know Now: An Update on College Drinking Research (NIAAA, 2007) go to http://www.collegedrinkingprevention.gov/1College_Bulletin-508_361C4E.pdf. Q&A with Fran Harding Fran Harding was appointed director of the U.S. Center for Substance Abuse Prevention in May 2008. Previously she served as associate commissioner of the Division of Prevention and Recovery, New York State Office of Alcoholism and Substance Abuse Services. In November 2006, Harding was appointed by the U.S. Department of Education to serve on the Review Group for the Department's Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention. This eight-member panel advises the department on the development and implementation of effective alcohol and substance abuse and violence prevention resources for the nation's institutions of higher education. In February 2008, Harding was appointed to the Council of Advisors for the Network Addressing Collegiate Alcohol and Other Drug Issues, a volunteer organization developed by the U.S. Department of Education in 1987. As the new CSAP director, how do you think federal agencies can best work together to advance prevention on a national level? A: One of my goals at CSAP is to increase collaboration among federal agencies and encourage that same collaboration on the state and local levels. We are in a very exciting time as far as prevention goes, with growing acceptance of prevention within a public health approach for reducing substance abuse. If we are going to further advance that agenda we need to have all the federal government agencies that have a substance abuse prevention component, to use a common language. Delivering the same messages and focusing on alcohol and other drug abuse as public health issues will be a large contribution to the success of the new administration. While CSAP does not itself conduct research, it does seek to translate research to practice through its Centers for the Application of Prevention Technology and other activities. Can CSAP also help shape research agendas to help communities and states better understand what works at those levels? A: Absolutely. For example, I have established regular meetings with national research agencies, including the National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, and Society for Prevention Research, to discuss our overlapping agendas and interests. CSAP also has connections at the state level through the National Association of State Alcohol and Drug Abuse Directors, which helps us hear from constituents on the needs in the field when it comes to research, such as what do we need from the researchers? Prevention in the 1990s received a lot of attention from the research community, which provided the science that forms the basis for the evidence-based practices and strategies that underpin current prevention and intervention. Now we need to advance research on environmental approaches that are effective with general populations. We need those program models and strategies so that we can better help the field. In addition, CSAP and NIDA have set up four symposia for CSAP staff to discuss the current trends and research. During the first session, NIDA wanted to know from CSAP what research was needed from the perspective of those working in the prevention field. We are also working with SPR the same way. For example, college students are one of the high-priority populations where additional research is needed. Those working in higher education need a better understanding of how best to change normative attitudes around alcohol on their campuses. I would like to see more research that examines the effectiveness of adopting and enforcing policies and then tying them in with campus and community prevention strategies. CSAP, NIAAA, and the Department of Education have advocated for environmental management initiatives to reduce high-risk drinking among college students. While some progress has been made in reducing problems on campuses and surrounding communities, there are still barriers implementing such initiatives. What do you think can be done to overcome those barriers? A: It will take time and persistence. For example, when we talk about changing cultural and social norms regarding alcohol and other drug use, we need to share the evaluation data on the implementation of successful evidence- based programs that have, in fact, begun to change those norms. People working in prevention often feel that they have no power to make changes, but if they understand the interrelationship between adopting and enforcing evidence-based environmental policies-such as reducing alcohol availability-and other activities aimed at changing the normative attitudes and behaviors of students, they will see that they do have the power needed to move forward. We need a consistent message that environmental-management strategies have to be matched with specific intervention programs. But, we must also examine where the drugs and alcohol are coming from in order to change the environment to make them less available to young people. Based on your almost three decades of experience working in the alcohol and other drug field, what do you think the most significant advances have been over those three decades? What do you think are the next big challenges? A: Without a doubt, the most significant advances have been in prevention research. We now have models, such as the logic model to guide the planning process of how to assess an environment, a community, a school, a family, and an individual to determine problems and needs. We can then rank the priority need and use the evidence-based practice or promising program model that matches up with that need in order to reduce or mitigate problems or risks. In the past, we have not been able to be that specific. For many years, people questioned whether prevention was successful. Now we have evaluation and research evidence to show that what we are implementing actually achieves results. That has turned heads in the community because we now have data that supports prevention. The second piece is helping communities and prevention practitioners learn how to use that data. It is very powerful to be able to use data to show if you do X, Y, and Z, then this is what you can expect to happen. I think that next big challenges will be getting more people to believe in this process and become active participants in health care reform. Prevention of alcohol and substance abuse-on college campuses or anywhere in the United States-needs to be part of the conversation around health care reform to help people understand that it is a public health response to a chronic progressive disease. We need people to be comfortable with the idea that this is something that we can prevent. We can prevent the disease of alcoholism and substance abuse. We can prevent problems related to alcohol and substance abuse on a college campus. We can do all of this if we help people understand that there is a logic to changing the attitudes and behaviors and intervening when necessary to stop problems. It is not good enough for us to know the science of effective prevention. We have to help everyone across the country speak the same common language about substance abuse prevention. I would like people to have dinner table conversations about what they can do themselves to lower the risk for alcohol and substance abuse or related problems in their families and communities. HOW OLD SHOULD YOU BE-TO BUY ALCOHOL? Currently all 50 states limit alcohol purchases to people aged 21 and over. But that hasn't always been the case. In fact, it was July 17, 1984, when President Ronald Reagan signed the national 21 minimum drinking age legislation into law, saying ". . . raising that drinking age is not a fad or an experiment. It's a proven success. Nearly every State that has raised the drinking age to 21 has produced a significant drop in the teenage driving fatalities." At that time only 23 states had minimum alcohol purchasing ages of 21 years old. The legislation called for withholding federal highway funds from the remaining 27 states if they did not follow suit. By 1988, all states had set 21 as the minimum drinking age. At the repeal of Prohibition states were given the authority to set minimum alcohol purchase ages, among other types of alcohol control policies. Nearly all designated 21 as the minimum legal drinking age, but between 1970 and 1975 29 states lowered the MLDA to 18, 19, or 20. That's also when the minimum age for other activities, such as voting, were also lowered. Then several studies in the 1970s found that motor vehicle crashes increased significantly among teens when the MLDA was lowered. With evidence that a lower drinking age resulted in more traffic injuries and fatalities among youths, citizen advocacy groups, such as Mothers Against Drink Driving, pressured states to restore the MLDA to 21. Because of such advocacy, 16 states increased their MLDAs between September 1976 and January 1983. Resistance from other states, along with concern that minors would travel across state lines to purchase and consume alcohol, prompted the federal government in 1984 to enact the Uniform Drinking Age Act, which mandated reduced federal transportation funds to those states that did not raise the MLDA to 21. Among alcohol control policies, the MLDA has been the most studied: since the 1970s, at least 70 studies have examined the effects of either increasing or decreasing the MLDA. Now, 25 years later, the 21 MLDA has come under fire from a former college president who maintains that it "hasn't reduced consumption but has only made it riskier." In 2007 John McCardell, former president of Middlebury College (1992- 2004), started an organization called Choose Responsibility to wage a national campaign to lower the drinking age to 18. Then, in early 2008 he started the Amethyst Initiative, a collective of college presidents and chancellors who are calling upon elected officials "to weigh all the consequences of current alcohol policies and to invite new ideas on how best to prepare young adults to make responsible decisions about alcohol use." At press time, the Amethyst Initiative had 135 signatories, including the presidents of such top-tier schools as Duke, Tufts, Dartmouth, and Johns Hopkins. But with colleges and universities numbering over 4,000 nationwide, Amethyst supporters are just a drop in the bucket. Mediterranean versus Animal House Style of Drinking This effort by college presidents urges national dialogue about policies that encourage adoption of the so-called Mediterranean drinking style. William G. Durden, president of Dickenson College and one of the co-authors of the Amethyst Initiative's presidential statement, said: "Perhaps the United States should act like countries with lower drinking ages, which have less of a problem with abusive drinking among youths but require stricter alcohol and drinking education in a nationally consistent manner, and inflict severe punishments on those who drink and drive" (Chronicle of Higher Education, Aug.27, 2008). At the American Public Health Association Annual Meeting in November 2008, Tom Babor, PhD, chair of the Department of Community Medicine and Health Care at the University of Connecticut, characterized Mediterranean drinking as follows: * Early introduction of youth to drinking in a family environment that accepts alcohol as a beverage and a nutrient, mainly to be consumed at meals * Low to moderate quantities per occasion * Many situations where drinking is normative * Informal social control of drinking * Alcohol integrated into the daily conduct of social life In contrast, Babor describes U.S. student drinking as the Animal House Drinking Style with: * High quantities per occasion * Many situations where excessive drinking is normative * Little social control of heavy drinking * Alcohol consumed to get drunk * Little integration with daily conduct of social life Babor says that this style of drinking is a outgrowth of what he calls the Animal House Initiative. "This is an effort by college students, facilitated by the alcohol beverage industry, to promote drinking as a normative rite of passage. The initiative is part of a global trend to make alcohol more convenient, attractive and available to young people through new product development, aggressive marketing targeted at young adults, and industry opposition to effective alcohol policies." In fact, he points out that while there is a Mediterranean style of drinking, there is also a pronounced trend towards the homogenization of drinking styles within Europe. In addition, being from a European Country with a lower drinking age is not protective for youth risky drinking. In examining findings from The ESPAD report 2003: Alcohol and other drug use among students in 35 European countries (Swedish Council for Information on Alcohol and Other Drugs and Council of Europe Pompidou Group, 2004) and Monitoring the Future national results on adolescent drug use 2003 (National Institute on Drug Abuse, 2004), Babor says that youths from most European countries are more likely to report drinking and intoxication and are more likely to report earlier age of first intoxication. And, U.S. youths are most similar to European youths from Portugal, France, Turkey, Hungary, and Sweden, which have low- frequency/lowintoxication patterns of consumption. Babor contends that these finding fly in the face of contentions by those who support lowering the MLDA that compared with Europe, the higher drinking age in the United States makes alcohol a forbidden fruit and causes U.S. youths to drink in riskier situations and in riskier styles. _____________________ Sidebar: France Says No to Young Drinkers Responding to concerns about young drinkers, France's National Assembly, the lower house of parliament, has moved to ban the sale of alcohol to teens under age 18 and subject violators to fines of up to euro7,500 ($9,400). French 16- year-olds have increased regular alcohol use from 1999 to 2007, going from 8 percent to 13 percent. And in 2007, almost one in five boys, and one in ten girls, reported at least ten drinking episodes during the month, according to the French Monitoring Center on Drugs and Addiction. Currently in France anyone 16 or older can order beer and wine in bars. The Assembly also voted to forbid the overnight sale of alcohol at gas stations, thought to be a prime source of booze for the young, according to an Associated Press dispatch. In addition, lawmakers voted to ban all-you-can-drink events in open bars popular with young people. _________________________ Not Traffic Safety Alone The National Highway Traffic Safety Administration says: "Perhaps no alcohol safety measure has attracted more research and public attention or shown more consistent evidence of effectiveness than the minimum legal drinking age (MLDA) 21 law in the United States (An Examination of the Criticisms of the Minimum Legal Drinking Age 21 Laws in the United States from a Traffic- Safety Perspective, October 2008). But the positive effect of the 21 MLDA is not limited to traffic safety. A number of studies have found that the 21 MLDA has also reduced alcohol consumption among 18 to 20 year-olds and is associated with reductions in other problems among underage youths, such as alcohol-related suicide and vandalism. And one review of MLDA studies concluded that "the benefits of the legal drinking age of 21 have occurred with little or no active enforcement in most areas. Simply by increasing enforcement levels and deterring adults from selling or providing alcohol to minors, even more injuries and deaths related to alcohol use among youth are likely to be prevented each year" (Journal of Studies on Alcohol?College Drinking, What It Is, and What To Do about It: A Review of the State of the Science, Supplement No. 14, March 2002). What Is To Be Done? While the college president's signing on to the Amethyst Initiative are "calling for a dialogue," McCardell describes a very specific alternative to the 21 MLDA for 18 to 20 year-olds. Those who take-and pass-a 40-hour alcohol education course and participate in 12 hours of community education, such as interviewing a recovering alcoholic, can obtain a so-called "drinking license" modeled after state sanctioned driver's licenses. But NHTSA says that there is no evidence to suggest that lowering the drinking age to 18 for those who complete an education program will reduce the likelihood of their drinking and driving, let alone make them a more responsible drinker. In addition, studies have shown that traffic safety education efforts alone are very good at raising awareness, but that in many cases they do not lead to behavior change. In addition, in Call to Action (2002) the National Institute on Alcohol Abuse and Alcoholism places prevention strategies that are informational, knowledge- based, or values clarification about alcohol and the problems related to its excessive use, when used alone, in what it calls "Tier 4: Evidence of Ineffectiveness." At the 2008 APHA Annual Meeting, Robert Saltz, PhD, senior research scientist at the Prevention Research Center in Berkeley, presented an overview of prevention research aimed at reducing high-risk drinking. He said that current research demonstrates that "we have the ability to create environments that help teens and young adults make healthy decisions about alcohol consumption. We have ample evidence that these strategies are effective and our greatest impact will come from adopting mutually-reinforcing policies and practices, including the 21 MLDA." The 21 MLDA enjoys wide popular support, with only 22 percent of respondents in the 2008 Nationwide Insurance Underage Drinking Survey agreeing that legal drinking age should be lowered from 21 to 18. But 75 percent said that there should be increased enforcement of underage drinking laws. As part of a national strategy to reduce underage drinking, the Institute of Medicine called for increased compliance with state minimum legal drinking age laws, saying that states should eliminate loopholes in minimum drinking age laws and states and localities should increase compliance through a range of strategies to limit commercial and social availability (Reducing Underage Drinking: A Collective Responsibility, September 2003). Commenting on the Amethyst Initiative in the Los Angeles Times (Aug.27, 2008) Robert Nash Parker, PhD, co-director of the Presley Center for Crime and Justice Studies at the University of California, Riverside, says. "It is ironic that these campus leaders call for 18- to 20-year-olds to 'choose responsibility,' when it is these college presidents who have shirked their responsibility to counter the dangerous binge-drinking culture that has developed on campuses. Research sponsored by the National Institute on Alcohol Abuse and Alcoholism has shown that there are effective strategies that will reduce student binge drinking. Instead, the presidents seem to have settled on approaches that will increase profits for alcohol companies at the expense of young people's lives and health. Until they do their homework, they get an F in public policy." TAXES AND HEALTH AND SAFETY Dozens of state governments this year are facing budget deficits that make a strong case for alcohol tax increases that serve a dual purpose: helping solve a state's fiscal problems while at the same time reducing the impact of alcohol consumption on the cost of protecting the public health and safety. The Wall Street Journal reported early this year that many state governments are facing their largest deficits in a generation. The problem is blamed on falling tax revenues combined with a rising demand for social assistance programs. Unlike the federal government, which can operate at a deficit, state governments are required to balance their budgets. Philip J. Cook, PhD, professor of public policy and economics at Duke University, says as many as 40 states may be exploring the possibility of increasing alcohol taxes. "Many of the states are desperate," he told Prevention File. "This might be the moment when it's possible to overcome the political power of the hospitality industry, the beer distributors and other alcohol-based industries." Those industries are well aware that the odds may be shifting against them. The Wall Street Journal reported in January that the Distilled Spirits Council of the United States (DISCUS) is enlisting restaurant and hotel associations as allies to combat tax proposals. "This will be an extremely tough year," said Peter H. Cressy, chief executive of DISCUS. Helping make it a tough year for DISCUS is an accumulation of evidence that nudging alcohol taxes upward will not only help states with their financial problems but will also help society at large. Studies have shown that increases in the price of alcohol can reduce drinking and driving and its consequences, lower the frequency of diseases, injuries and deaths related to alcohol use and abuse, and reduce alcohol-related violence and other crime. A vast amount of research confirms the connection between alcohol prices and alcohol consumption. Alexander C. Wagenaar, PhD, a professor of epidemiology at the University of Florida, reported early in 2009 that a review of studies spanning four decades has confirmed the price-consumption connection. "Results from over 100 separate studies reporting over 1,000 distinct statistical estimates are remarkably consistent, and show without doubt that alcohol taxes and prices affect drinking," he said in a report published in the journal Addiction (February, 2009). "When prices go down, people drink more, and when prices go up, people drink less." The case for raising alcohol taxes is also compelling for historical reasons. In most states, alcohol taxes have not been increased for many years. Moreover, the taxes are usually levied on the volume of alcohol sold-not its value. Inflation has eroded the real value of per-gallon or per-barrel taxes on beer, wine and spirits until they are negligible in relation to the retail price of the product. And during the years that taxes have remained low, the cost of dealing with the consequences of alcohol consumption have risen steadily. Cook demonstrates how alcohol tax policies have actually reduced the real price of alcoholic beverages. He points out that Congress in 1951 set the federal alcohol tax at $1.68 per fifth of distilled spirits. In today's dollars, that's the equivalent of $13.50 per fifth. "But Congress has only succeeded in raising the tax twice since 1951, and by meager amounts, so that instead of $13.50, the current tax is just $2.16 per fifth. The result is that the current price of a bottle of spirits is over $10 lower than it would have been if Congress had simply indexed the tax to the Consumer Price Index and then left it alone," says Cook, whose book Paying the Tab (Princeton University Press, 2007) chronicles the history of America's frustrating effort to develop rational alcohol policies. Cook told Prevention File that alcoholic beverage producers appear to be basing an anti-tax campaign on the argument that the hospitality industry is suffering more than some others from the nation's economic downturn and it would be unfair to saddle it with higher alcohol taxes. "Actually, they're using the same argument they've always led with-that there are a lot of jobs that depend on alcohol, that it's an important industry in every state and congressional district, so we'd best leave it alone." When an alcohol tax increase is tied in with support of a public health goal, such as expanding treatment opportunities for people with alcohol dependence, the industry's argument about job losses is weakened, Cook points out. "If employment falls in the alcohol industry as a result of the tax, it will increase in other industries getting new support from the tax." Interest in raising state alcohol taxes ranges from coast to coast, with the alcohol and hospitality industries mobilizing for a fight. Gov. Arnold Schwarzeneggar proposed a "nickel a drink" tax increase on beer, wine and distilled spirits in California, triggering a cry from DISCUS that this would cause the loss of 20,000 jobs in the state. In New York, Gov. David Peterson is proposing a similar tax increase, hoping to head off protests from New York's vintners by proposing also that a state law now limiting the sale of wine to liquor stores be changed to allow wine to be sold in grocery stores. Kentucky is considering a tax increase that would add 25 cents to the cost of a six-pack of beer. Wisconsin legislators have received a proposal to raise alcohol taxes in order to raise the pay of district attorneys and hire more assistant DAs. In Wyoming, where alcohol taxes have not been changed since 1935, legislators are considering an increase to finance programs to reduce underage drinking and other alcohol-related social problems. Early in 2008 Maine's legislature passed a bill doubling state taxes on beer and wine to raise revenue for health care. With help from the alcohol industry, opponents of the tax increase waged a successful initiative campaign to repeal the measure in the election last November. Some states trying to relieve budget shortfalls are looking toward alcohol tax revenue from a different vantage point. Last year, Colorado lifted a ban on Sunday sales of distilled spirits with the expectation of a 7 percent increase in alcohol tax collections. Similar policies have been proposed or adopted in several other states that otherwise limit Sunday sales. Those states which permit "local option" to set the rules for alcohol sales within specific counties are considering a change for the sake of increasing the state's revenue from alcohol taxes. As prevention advocates point out, policies that make alcoholic beverages more available for the sake of collecting more tax revenue could be self-defeating. Gains in tax collections would be offset if not wiped out by increases in the cost of law enforcement, medical care and other consequences of alcohol consumption. ____________________________ Sidebar: A Nickel-a-Drink = $80 Million in Maryland Maryland lawmakers are considering a 5-cent tax on alcohol. The current tax amounts to about 2 cents in state taxes per glass of wine or shot of liquor or 1-cent in taxes for a 12-ounce beer. The proposed increase would be the first in more than 30 years. Like other state that are considering alcohol tax increases in order to respond to mounting deficits and increasing costs for providing services, Maryland's proposed tax increase would fund the state Developmental Disabilities Administration, as well as alcohol- and drug- treatment programs. Kate Rollason, executive director of the Arc of the Central Chesapeake Region said: "Bars aren't going to lose any money. And people probably won't even notice it" (The Capitol, Mar.10, 2009). ___________________________ "We're getting daily requests for assistance and information about alcohol taxes from a great variety of places," says George Hacker, JD, director of the Alcohol Policies Project of the Center for Science in the Public Interest. Hacker told Prevention File he believes that backers of alcohol tax proposals would be wise to adopt a two-pronged strategy, pointing out that the tax increase would not only help balance a state budget but would also help the state's economy by providing funds for treatment and prevention of alcohol problems. "Many treatment programs are now being threatened by the squeeze on state budgets. Those programs can move people from dependence to a more active and productive involvement in society," he said. "It varies by local and state politics, but in terms of public support an alcohol tax increase has the greatest amount of public backing when it's tied to some beneficial use-such as rehabilitating addicted people in the criminal justice system, or reducing underage drinking, or enforcing rules against intoxicated driving. People generally don't like to see the money just poured into the deep, dark hole of government." A proposed tax increase can gain 10 to 15 percent in public support when it would provide funds for a beneficial use, says Hacker. CSPI reports that in one national survey nearly 73 percent of adults supported an increase in the tax on beer to pay for substance abuse programs. What about federal taxes on alcohol? While Congress is not under constitutional pressure to adopt a balanced budget, alcohol taxes often come up for review when red-ink budgets are looming, Hacker says. The Congressional Budget Office has offered the option of increasing the federal tax on distilled spirits by about 20 percent-raising it to $16 per proof gallon-and then equalizing the tax on beer and wine on the basis of their alcohol content. "That would raise about $28 billion over five years, and my guess is that it will get more discussion and attention this time in Congress than in previous years," says Hacker. "But the industry is not going away. It has a significant political presence in Washington, but perhaps its influence with the new administration may not be as great as it has been in the past." Although for a growing number of people, increases in alcohol excise taxes seem to be a good way to alleviate budget deficits, It's still a hard sell. In California the proposed increase didn't make it into the Governor's budget. But the state could still generate an additional $1.2 billion in revenue annually by increasing its excise tax on alcohol if a new bill proposed by San Jose Assemblyman Jim Beall becomes law. His bill would increase the tax by approximately 10 cents per drink for beer, wine and distilled spirits, raising the tax on alcohol for the first time since July 1991. Beall says the tax money would be devoted to emergency services, alcohol and drug treatment programs and law enforcement operations related to alcohol and drug abuse. _________________________ Sidebar: Alcohol Policy 15 Policies for Reducing Problems Associated With Alcohol Availability The 15th in a series of conferences on the avoidance of alcohol-related problems using public policy strategies When? TBA during either the second half of 2010 or first half of 2011 Where? Washington, DC (tentative) Why now? The new federal administration has signaled a renewed interest in science and public health. Meanwhile, states and localities are facing increased demand for public services in the face of declining revenues. Evidence-based alcohol policy can reduce alcohol problems and resultant social costs, simultaneously generating revenue (alcohol excise taxes and other user fees) to promote public health and safety. Who should attend? We welcome an anticipated attendance of up to 300 participants, including community-based practitioners, public officials, and researchers from across North America and beyond. More information Call for abstracts, scholarship availability, exhibit opportunities, and accommodations forthcoming via silvergategroup.com/ap15. Reach Silver Gate Group staff by e-mail -tomc@silvergategroup.com _____________________________ Be Prepared! Emergency-a serious situation or occurrence that happens unexpectedly and demands immediate action. Every year colleges and universities are called upon to respond to a wide variety of emergency and crisis situations- ranging from tragic shootings and alcohol-fueled disturbances to severe weather events. Institutions of higher education face many challenges in practicing emergency management related to the distinctive structure and environment of higher education. To help them meet those challenges the U.S. Department of Education recently released Action Guide for Emergency Management at Institutions of Higher Education. IHEs have structures and environments that make them quite different from typical businesses- they often cover large geographic areas, the campus population is in constant flux, may operate complex enterprises in addition to academic programs, and operate almost around the clock. The Guide points out that such "structural and environmental characteristics pose challenges for access control, monitoring movements, defining boundaries for facilities and grounds, standardizing procedures and decision-making processes, and prioritizing resource allocations." The Guide calls out nine key principles serve as the foundation for developing effective emergency management plans as follows:. * Senior leadership on campus. The president, chancellor, or provost must initiate and support emergency management efforts to ensure engagement from the entire campus community. * Partnerships and collaboration. Every department responsible for creating a safe environment and enhancing campus functions must be involved in planning efforts. * An "all-hazards" approach to account for the full range of hazards that threaten or may threaten the campus. Rather than managing planning initiatives for a multitude of threat scenarios, all-hazard planning develops capacities and capabilities that are critical to prepare for a full spectrum of emergencies or disasters, including natural hazards and severe weather, biological hazards, and violence and terrorism * Four phases of emergency management to effectively prepare and respond to emergencies. Part of the founding principles of comprehensive emergency management when the Federal Emergency Management Agency was created in 1979 is the four phases of emergency management: Prevention-Mitigation, Preparedness, Response, and Recovery. * Comprehensive design, while also providing for staff, students, faculty, and visitors with special needs. Any procedures, products, and protocols created to prevent, prepare, respond, and recover from an emergency also must accommodate people with various levels of cognitive ability, knowledge, physical capabilities and life experience. * Comprehensive planning process that addresses the particular circumstances and environment of the institution. The plan must be based on the unique aspects of the campus. * Trainings based on the institution's prevention and preparedness efforts, prioritized threats, and issues highlighted from assessments. Training should be conducted in conjunction with community partners, as well as integrated with responders' expertise, to ensure consistent learning. * Tabletop exercises prior to fully adopting and implementing the emergency management plan. These exercises should cover a range of scenarios that may occur on the campus, and should be conducted with a variety of partners and stakeholders from the campus and the community. * Disseminate information about the plan to students, staff, faculty, community partners, and families. General plans and procedures can be posted around campus or displayed on a Website. Emergency Preparedness at Purdue Purdue University, West Lafayette, IN, is one of 17 colleges and universities that received an U.S. Department of Education Office of Safe and Drug-Free Schools Emergency Management for Higher Education Grant in 2008. Established in cooperation with the Department of Health and Human Services' Substance Abuse and Mental Health Services Administration, this grant program provide funds for higher education institutions to develop, or review and improve, and fully integrate campus-based all-hazards emergency management planning efforts for higher education institutions. Purdue has developed a Campus Emergency Preparedness and Planning Office (www.purdue. edu/emergency_preparedness/) that "strives to ensure the Purdue family is prepared for emergencies." Purdue's Website illustrates that an emergency can cover a wide swath of events, including a pandemic flu epidemic and a tornado. In addition to providing a comprehensive emergency preparedness handbook that covers events from crime and violence to an electrical failure, the Website also links to community resources, such as the local crisis center and health department and the state and federal homeland security offices. Like many campuses, Purdue is a large and complex institution, with people moving about campus freely. In order to get warnings and information out to as many people as possible as quickly as possible it has developed an emergency warning notification system called Purdue ALERT. It's a multi-layered approach in place to help spread the word quickly, based on the circumstances. For example, all hazards emergency warning sirens alert people to immediately seek shelter in a safe location within closest facility or building during a tornado, earthquake, release of hazardous materials in the outside air, or a civil disturbance. Another communication too is text messaging. Purdue University faculty, staff and students may sign up to receive an emergency notification text message. The goal of the Office, which was established in 2006, is "to provide a means to utilize all available resources to prepare for potential emergencies or disasters whenever possible and deal efficiently with the effects of inevitable events, respond to save lives and protect property, and promote a means to recover mission critical business and academic operations." Planning Through Recovery at Virginia Tech Even with the most careful planning, it is difficult to anticipate all the impacts of an emergency on campus. At the U.S. Department of Education's 22nd Annual National Meeting on Alcohol and Other Drug Abuse and Violence Prevention in Higher Education in November 2008, Mark McNamee, PhD, senior vice president and provost at Virginia Tech, spoke about the importance of planning through recovery in the aftermath of the April 16, 2007 shootings that claimed the lives of 32 students and faculty on his campus. McNamee said that there were a number of unexpected experiences in the immediate aftermath of the shootings. For example, the number of individuals impacted and the need for services is exponentially amplified by number of victims. Regular individuals, not trained in emergency services or aware of the institution's emergency plan, will be pressed into service. And while many campus individuals and units are trained and responsible for emergency response, untrained individuals will be pressed into service and may not have the knowledge of the plan. "Red Cross and government officials will arrive, and not everyone at the institution will understand the legitimate role these organizations have in emergency response and management. You might be overwhelmed by the out-pouring of assistance-helpers will arrive, in droves, asking to be assigned a role, and some demand VIP treatment," said McNamee. According to McNamee, the magnitude of the media presence added "trauma" to the campus and the victims. "While most were respectful, some media members were relentless in their pursuit of a 'story' in the immediate aftermath. For example, some reporters tried to pass themselves off as family members and/or as clergy members to gain access to victims," he said. As for the intermediate aftermath of an emergency or tragedy, McNamee said that campuses may draw unwanted attention and attract individuals and groups with undesirable agendas to the institution. "Also, you may need to address the attraction of mentally unstable individuals who may be drawn to or relate to the tragedy. This will be true at the 'anniversary' of the event and other event 'markers.' "At Virginia Tech, we assigned a family liaison to work with the families of the deceased. This idea was good on many levels: it helped provide on-site and local assistance, initially helped with communications," said McNamee. However, he added, the liaisons could have benefitted from the help from a trained victim assistance person the ability to access victim services, such as compensation and other resources. McNamee pointed out that accepting donations and funds are a mixed blessing. "Trauma and grief are emotions of action. Virginia Tech was flooded with food that could not be used in the immediate aftermath; followed by flowers, gifts, banners, teddy bears, candles, hundreds upon hundreds of town/county/government proclamations. Gifts need to be acknowledged, archived, and-eventually-you will need to articulate a disposal policy. Funds received may challenge your institution's federal and state tax-exempt status. It is a challenge to manage monetary gifts-are they to be distributed to the victims? Do you want to establish a reimbursement system? Are funds intended for the institution? These questions are difficult to answer in the immediate aftermath and may shape the relationship you develop with the families of deceased and injured victims." McNamee cautions not to underestimate the length of time leaders and others at the institution will be involved with victims. This may have implications for how to assign "tragedy-related" duties to campus personnel and secure the assistance of people external to the institution. "For example, Virginia Tech retained a loyal alum-Jay Poole-to direct the office of recovery and support. He was not on campus the day of the shootings, and was asked to help with management of information and provided assistance to president with communications and relationships with the victims," he said. "You cannot plan for leading through the high degree of ambiguity and uncertainty that people feel in the immediate and longer-term aftermath of the tragedy. There is a need for adaptation, the application of improvised alternatives, the employment of multiple methods of responding, responding to the diversity of expressions of grief, and the varying needs and opinions about what is needed for response and recovery," McNamee said. Editor's note: For a copy of the Action Guide for Emergency Management at Institutions of Higher Education go to www.ed.gov/emergecyplan. For the full presentation by Mark McNamee go to rems.ed.gov/views/documents/ EMHE_20081118MN_PlenaryMcNamee.ppt BOOK REVIEW College Drinking: Reframing a Social Problem By George W. Dowdall Praeger, 2009 ISBN: 978-0-275-99981-0 Problems related to student drinking have a long history at colleges and universities. In fact, surveys of campus officials, faculty and even students find that alcohol problems rank high among campus life issues. George Dowdall, PhD, is a professor of sociology at St. Joseph's University with over three decades of experience on college campuses at institutions ranging from Harvard to UCLA. In 2000, he was an American Sociological Association Congressional Fellow with then U.S. Senator Joseph Biden of Delaware. His academic experience along with a well-grounded understanding of the research literature surrounding college drinking and working relationships with many of the people who have shaped that research have led to College Drinking: Reframing a Social Problem. In this new book, Dowdall advocates for an upstream perspective when it comes to drinking by college students. By that he means understanding the broader cultural, organizational and social forces shaping collegiate drinking behavior. "Much of the research literature about college drinking looks at downstream behavior at individual colleges, well after students have begun drinking and after they've chosen a particular college. College drinking is part of a pervasive and deep-rooted college culture, one that shapes individual student behavior as well as the organizational responses that higher education had made to this behavior, But like all real cultures, this one is filled with contradictions and serves different interests in different ways. Students and their parents place it at the top of the list of problems colleges face; presidents, administrators, and faculty treat this problem differently," says Dowdall in the book's preface. Dowdall covers college drinking as it has evolved as an issue in recent decades and why students engage in excessive drinking, as well as adverse consequences associated with drinking, such as health problems, poor academic performance and campus crime. The book also examines the links between college drinking, social life, and sex; public alcohol policy and college drinking; the response of higher education to the problem to date; additional measures and strategies that colleges and universities could employ; and what students and parents can do to cope with college drinking, including strategies for choosing which college to attend. In the chapter on public alcohol policy and college drinking, Dowdall argues that public alcohol policy is one of the important factors shaping college drinking. "Alcohol policies shape how alcohol is produced, distributed, marketed, and sold; what can be done about college drinking; and even the discourse about college prevention programs. Recent evidence supports the argument that upstream factors like policy may be as important-or even more important-than downstream efforts to prevent or control individual drinking." College Drinking: Reframing a Social Problem provides a wealth of material and resources to assist professionals and general readers alike gain a greater understanding of a social problem that routinely commands public attention in the media. In addition, the book suggests actions that the public, officials at institutions of higher education, and parents and students alike can take to address the behavior of high risk drinking by students and reduce problems that impact not just students and their families, but campuses and surrounding communities. Editor's note: For an interview with George Dowdall on his book visit Inside Higher Education at www.insidehighered.com/ news/2009/02/26/drinking.