Binge Thinking

Henry Wechsler has defined the student-drinking problem, for better or worse

Henry Wechsler is sounding the alarms again. That is what you do when you see

academe as a landscape lined with “party houses awash in a sea of alcohol,” a culture imperiled by destructive drinking traditions, a community with too few guards at the gates.

Mr. Wechsler, director of the Harvard School of Public Health College Alcohol Study, knows how to speak in the foreboding tones that catch the ears of parents and college presidents.

Over the past decade, he has popularized a controversial definition of “binge drinking” and conducted landmark surveys revealing that students are boozing more heavily and more frequently than previously thought.

Today, the student-drinking problem is not getting any better, he says, in no small part because many administrators and campus health officials are willfully ignoring the problem.

Mr. Wechsler’s latest warnings are contained in a new book, Dying to Drink: Confronting Binge Drinking on College Campuses (Rodale Books, 2002), which he co-wrote with Bernice Wuethrich, a science writer. While the title evinces Mr. Wechsler’s apparent fondness for puns, the book is a serious rendering of the problems associated with college drinking. Based largely on findings from the Harvard program’s continuing survey, Dying to Drink includes firsthand accounts from students, indictments of the alcohol industry, and proposals for diminishing the prevalence of alcohol on campuses.

Mr. Wechsler has been widely praised for repeatedly publicizing the many costs of student drinking. His supporters, who include college leaders and fellow researchers, have called him a pioneer, a hero, even “higher education’s Paul Revere.”

But his critics have other names for him, including “Doctor Doom” and “Chicken Little.” Many alcohol-prevention experts and researchers challenge the validity of his studies, arguing that his interpretations of the data overstate the severity of the drinking problem.

Mr. Wechsler and his research team have repeatedly mined their work, publishing dozens of articles in various journals -- and prompting charges that he has flogged the material for maximum publicity. Though he has produced some findings that were surprising, some others seem fairly obvious: that members of fraternities drink more than other students. And that the extent to which people living near a campus experience secondhand effects of student drinking is related to the rate of drinking on campus, and to the number of alcohol outlets in the neighborhood.

Campus health educators agree that alcohol abuse is a serious problem among some students. At the same time, some allege that Mr. Wechsler’s message may perpetuate high-risk drinking among students by convincing them that many of their peers are drinking more than is actually the case. And by criticizing programs that emphasize moderate drinking, Mr. Wechsler has angered some people in the alcohol-prevention field, who see him as too rigid, too absolutist in his approach.

Is it possible that the man who sounds the alarms is not the best agent for change?

“The College Alcohol Study placed the issue squarely on the front page and delivered a wake-up call to the country, so I tip my hat to Henry -- I’m indebted to him,” says Robert J. Chapman, coordinator of the Alcohol and Other Drug Program at La Salle University. “But the traditional scare-'em-to-death campaigns are not the way. ... You don’t beat a wasp’s nest with a stick.”

Mr. Wechsler sees such criticism as an attempt to play down the seriousness of student drinking.

“Some colleges are pushing the issue back into the closet,” he says. “I’ll be damned if I’m going to let people divert attention away from the drinking problem.”

Looking for Answers

Despite his hard-line stance on the issue, Mr. Wechsler bristles at any comparison to Carry Nation. He’s no teetotaler -- he sometimes orders a drink, to show just that -- and enjoys the occasional glass of Merlot or a single-malt scotch.

On a Thursday afternoon in October, it’s a half-pint of Guinness. Mr. Wechsler accepts an invitation to sit down and talk with a reporter at the Kells bar, a student hangout just down the street from Boston University. The Kells is a pseudo-Irish pub, with green walls, wood paneling, and a slew of beers on tap. From the floor wafts the smell of cleanser and last night’s drinks.

Mr. Wechsler, short, stout, and graying at 70, wears large, rounded spectacles that give him an owlish look. As a Jennifer Lopez song pounds from a nearby speaker, he surveys the empty bar. He seems comfortable enough, if somewhat fidgety. “I’m not dressed for this place,” he says, removing his tie.

The soft-spoken Mr. Wechsler is hard to picture as such a polarizing figure in his field.

Born in Warsaw in 1932, he fled with his parents in 1939, just before German forces invaded. The family moved from country to country in Europe before arriving in New York and settling in Manhattan in 1941.

Mr. Wechsler was drawn to social psychology, he says, because it promised to provide answers to “personal questions about the war, the Holocaust, how these things could happen ... what makes people behave the way they do.”

His parents drank, but not much. He did his first social drinking in high school, “a few beers” with friends. He saw a lot of drinking as an undergraduate at Washington and Jefferson College, in rural western Pennsylvania, but says most students in his day were not “drinking to get drunk.” He was a regular at “sherry hours,” where students gathered in professors’ homes to sip drinks and talk about current events.

Mr. Wechsler caught his first glimpse of the booze-soaked culture he would later criticize on a debate-team trip to Pennsylvania State University, where he found himself in the middle of a St. Patrick’s Day party.

And what did he see?

“Vomit. There was heavy drinking going on, ritualistic drinking. It was out of control.”

Green beer was flowing. Mr. Wechsler had a few, but no more. He remembers being struck by the way some of his friends on the debate team willingly lost control of themselves as they drank and drank. “I didn’t enjoy beer that much, and I wanted to be in command of my faculties,” he says.

Mr. Wechsler received his Ph.D. in social psychology from Harvard in 1957 and eventually decided to pursue studies in public health. At a time when much of the public’s attention was on marijuana and other drugs, he saw alcohol as a limitless field of inquiry, bound up as it is in the traditions of so many cultures and religions, and producing both positive and negative effects.

After taking a research position at the Medical Foundation, in Boston, in 1965, Mr. Wechsler studied the drinking habits among students at high schools and middle schools in the area, then moved on to conduct regional studies of alcohol abuse among college students. In studying how environments influenced drinking, he found that in large, anonymous institutions, students tend to use alcohol as a way of banding together.

Mr. Wechsler, who married and raised three children in the Boston suburbs, became a lecturer in the department of health and social behavior at the Harvard School of Public Health in 1966. For decades, his was a quiet life, spent teaching classes, crunching numbers, and taking out his stress on the squash courts of the Harvard Club.

George W. Dowdall, who worked on Harvard’s College Alcohol Study in the mid-1990s, says Mr. Wechsler, though adept at spotting patterns in stacks of data printouts, was not a typical researcher.

“A lot of people get bogged down in numbers without realizing that the numbers are summaries of the lives of individuals, but Henry has the imagination to go past the dry survey data,” says Mr. Dowdall, who is now a professor of sociology at Saint Joseph’s University, in Philadelphia. “He can empathize with the people he hasn’t met except through his data -- which is an exceptional quality for a researcher.”

His Big Break

Mr. Wechsler won the chance to reach more students than ever in 1992, when he received a $1.9-million grant from the Robert Wood Johnson Foundation to conduct a survey that would produce a broad, detailed picture of student drinking. The College Alcohol Study was unprecedented in its scope. Mr. Wechsler and his research team mailed detailed questionnaires to random samples of about 200 students at each of 140 colleges and universities.

The survey, which found that more than two in five of the students were regularly drinking five or more drinks in a row, demonstrated a relationship between the amount of alcohol that students drink and the frequency with which they experience “secondary effects,” including date rape, violence, and academic troubles. Using that information, Mr. Wechsler was able to evaluate the drinking habits of specific types of students, including fraternity and sorority members and athletes.

The foundation followed up the study with a dissemination grant to help publicize the survey. In a strategy that would be repeated, Mr. Wechsler’s team hired a marketing firm to broadcast its findings to the general public.

“That blew it out of the box,” says Marianne Lee, project director of the College Alcohol Study at the time. “We came out one day, and there were seven TV cameras outside the School of Public Health. We were taking calls from Australia.”

Mr. Wechsler made the media rounds, appearing on TV shows, including Nightline and Good Morning America, wrote newspaper editorials, and issued news releases on his studies. His mission: To convince college officials that they had become numb to a severe problem on campus. “It’s like living near a bad smell -- you get used to it,” is one of his favorite sound bites.

Following the alcohol-related deaths of students at several academically elite institutions in the mid-1990s, Mr. Wechsler’s findings provided the statistical drumbeat for a growing national concern about drinking on campus. For the many colleges that began trying to reduce student drinking, Mr. Wechsler’s studies were crucial tools.

“He gave us a broad frame of reference to try to understand what the causes, scale, and harmful results were of excessive drinking,” says the Rev. Edward A. Malloy, president of the University of Notre Dame and co-chairman of the National Institute on Alcohol Abuse and Alcoholism’s subcommittee on college drinking. “His research helped campuses get a handle on where they stood. His work was a springboard for looking into the problem.”

The Robert Wood Johnson Foundation has continued to finance the College Alcohol Study, which has conducted follow-up surveys in 1997, 1999, and 2001. About $5.5-million has gone to the project itself since 1992, with an additional $1-million for marketing, part of which Mr. Wechsler has used to contract with Burness Communications, a Maryland firm that handles much of his public-relations work.

Mr. Wechsler says that he doesn’t particularly like the publicity that has come from his position, but that he feels a responsibility to speak for his research.

While most of Mr. Wechsler’s fellow researchers are grateful for his data, some say he has chosen to harp on the problem rather than propose solutions. Part of the resentment that has ensued may be sour grapes, but some of his peers insist that it’s more.

Ms. Lee, who left the study after a falling-out with Mr. Wechsler and who no longer works in the field, says some of the criticism is warranted. “He hasn’t evolved,” says Ms. Lee, who was executive director of the Governor’s Alliance Against Drugs, in Massachusetts, before working on the College Alcohol Study. “In the beginning, it was appropriate to scare people. He’s an advocate. He feels very passionately about the issue. But what Henry hasn’t grasped is that you can change your message and still be heard. It’s been 10 years. You don’t go out and sing the same songs for 10 years and change everyone’s behavior.”

Battle of the Binge

To be fair, Mr. Wechsler set out to study the extent of the problem, not to come up with a big solution. But a running criticism is that he has made the prevention of alcohol abuse more difficult by making “binge drinking” a household term and defining it in a very broad way. Mr. Wechsler did not coin the phrase (it first appeared in an earlier study), but he makes no apologies for hammering it into the vernacular.

Binge drinking, as defined by the College Alcohol Study, means five or more drinks in one sitting for a man, or four or more for a woman, on at least one occasion in the previous two weeks. Mr. Wechsler’s surveys have consistently shown that two out of five college students fit that profile.

The overall rate of drinking among students has remained constant, and there are fewer moderate drinkers and larger numbers of both frequent binge drinkers and abstainers than there were a decade ago, the study has found.

Critics have argued that “binge drinking” labels too many students as problem drinkers, creating an exaggerated picture of alcohol abuse on campus. A number of researchers and colleges, as well as the Journal of Studies on Alcohol, have refused to use or endorse the term; they say it is misleading.

Although Mr. Wechsler calls this particular debate “a lot of fuss over nothing,” it is more than a semantic scuffle. Many educators and students who are on the front lines of campus alcohol-education programs insist that the definition hinders colleges’ efforts to reduce drinking. Mr. Wechsler’s constant emphasis on binge drinking “promotes the idea that everybody who drinks at your school drinks to excess,” says Corey Fischer, a chemical-health educator at the University of Minnesota at Duluth. “Students see that message in the media, then they come to me and say, ‘I’m not an alcoholic.’ Why would they listen to a message if they think that the term doesn’t apply to them? My big frustration with Henry is that he clings to his term, his definition.”

Critics deride the 5/4 definition as a “magic cutoff point” that overlooks a person’s body weight and the length of time over which the drinks are consumed, factors that influence the physiological effects of alcohol consumption. They point to researchers who have found that many students don’t reach blood-alcohol concentrations associated with mental and physical impairment even when they have drunk enough to qualify them as binge drinkers under Mr. Wechsler’s definition.

Mr. Wechsler counters that critics of the term are looking at the label, not the problem. “Culture socializes us to see drinking in terms of legal issues of impairment,” he says. “Critics of the term are stuck on the idea that a student must be intoxicated for there to be [alcohol-related] problems.”

The 5/4 measure is a “danger sign,” a threshold after which students are much more likely to experience problems because of their drinking, he argues. “I’m not using a pretty word. It’s a descriptive term. Is it pejorative? Do students resent it? I don’t see it as any more pejorative than ‘high-risk drinking.’ I’m not calling them drunks.”

Saying ‘No’ to Norms

Not only has Mr. Wechsler created a rift in the prevention field by popularizing the controversial notion of binge drinking, but he has deepened the divide by condemning an increasingly popular prevention approach -- social-norms programs, which are designed to reduce campus drinking by emphasizing the “norm” of moderate drinking among students.

Social-norms programs are based on the idea that students typically overestimate the amount that their peers drink, prompting them to drink more to keep up with their own perception of “normal” behavior. The theory is that if students receive complete information about the actual drinking habits on campus -- that is, that the majority of students are not heavy drinkers -- they themselves will drink less.

Michael P. Haines, director of the National Social Norms Resource Center, at Northern Illinois University, is one of the leading advocates for this approach. A decade ago, he helped start the first social-norms marketing campaign for students at Northern Illinois, which since 1990 has seen a 36-percent increase in the number of both self-described moderate drinkers and abstainers, as well as a steady decrease in alcohol-related injuries.

“It’s a contrast to authoritarian approaches that are top-down, social-control models that threaten students with punishment or the fear of death,” Mr. Haines says. “The social-norms model, done correctly, is driven by the students themselves. It’s positive, not coercive.”

Campuses develop their own programs by polling students, then publicizing data about student-drinking habits (typically via posters emphasizing that the majority of students aren’t drinking heavily), then polling students again to measure changes in their perceptions and behavior. A number of institutions, including California State Polytechnic University, Hobart and William Smith Colleges, the University of Arizona, and the University of Virginia, report that their social-norms programs have proved effective in recent years.

There is a parallel between social-norms campaigns to reduce drinking and campaigns to promote safe sex: Both emphasize healthy behaviors, without preaching abstinence. “Students are very sensitive to interventions that are finger-wagging,” Mr. Haines says. “They are supportive of policies that keep them from alcohol-related harm. ... But they don’t [say], ‘Keep us from drinking.’”

While there are numerous case studies to support social-norms strategies, there has not been a large national study of the programs’ effectiveness to date. The U.S. Department of Education and the National Institute on Alcohol Abuse and Alcoholism are financing $4-million study of social-norms programs that is scheduled to end in 2004.

Mr. Wechsler calls social-norms programs “feel good” approaches that are based on faulty premises: that there is such a thing as a typical student, and that students who are already high-risk drinkers are inclined to lower their own intake just because other students are drinking less.

“Find a school where they have social-norms signs up on campus, and you’ll find a school with a drinking problem,” he says. “What makes this so attractive to universities and colleges is that it makes the problem look like it is less severe than it actually is -- it takes the heat off of them. And alcohol companies are happy because there’s no cutting into their sales.”

In fact, if the social-norms movement has an albatross, it is the alcohol industry’s recent embrace of such programs. Anheuser-Busch, for instance, helped finance the establishment of the Northern Illinois center, in 2000, and has given $2-million to establish social-norms programs at four universities. The brewery is also a contributor to the Bacchus & Gamma Peer Education Network, a Denver-based coalition of colleges that deals with student health issues and supports social norms.

Proponents of social norms say the backing of prevention programs with beer money is not evidence that the fox is guarding the henhouse, as Mr. Wechsler alleges.

“If the alcohol industry has no role in the process, you have no way to impact the industry,” says Drew Hunter, executive director of Bacchus & Gamma. “The auto industry is a major player in auto-safety research, and there’s no reason that alcohol companies can’t be part of the solution.”

Some social-norms proponents have noted that Mr. Wechsler’s dim view of the potential of social norms runs contrary to his view of the power of alcohol-related advertising. In some passages of his new book, students are described as if they were prey who needed protection from “insidious” television commercials and other forms of advertising that can “seduce young people already drunk at the bar with solicitous sounds, shapes, and colors.”

So while Mr. Wechsler believes that media-driven messages are a bad influence on student drinking, he refuses to concede that positive messages, delivered through campus media campaigns, may have the power to help change students’ behavior.

Proponents of social norms note that in 1996, Mr. Wechsler co-wrote an article in the Journal of Drug Issues that suggested a relationship between what students perceive and how much they drink. He says the findings in the article, “Variation in Perceived College Drinking Norms and Its Impact on Alcohol Abuse: A Nationwide Study” did not pave the way for the social-norms strategy that he is seeing today.

“The way it’s being practiced now -- that simply by lowering students’ perceptions you can make them drink less -- is a gross oversimplification of the problem,” he says. “This is not just a question of the number of drinks consumed, but the culture of alcohol that influences students’ perceptions.”

The Big Picture

Mr. Wechsler takes on that culture, from top-to-bottom, in Dying to Drink. While much of his research has focused squarely on the campus, his book zooms out to capture a large, complex picture of the student-drinking issue.

He criticizes the alcohol industry for a variety of wrongs, particularly advertising aimed at young people, and condemns the financial relationship between “Big Alcohol” and many colleges.

He also proposes “environmental” strategies for college communities, like stepping up enforcement of drinking laws, raising the price of alcohol, and reducing the number of bars near campuses. And he urges colleges to promote more alcohol-free events, ensure that fraternities are enforcing the drinking age, and provide better treatment to students at risk of alcohol problems.

Mr. Wechsler also takes a number of shots at other fixtures in the alcohol-abuse-prevention field, notably the Higher Education Center for Alcohol and Other Drug Prevention, in Newton, Mass., which “boasts of its policy of emphasizing positive and downplaying negative news about college substance abuse ... reflect[ing] the disjointed nature of the federal government’s response” to college drinking, he writes.

To some fellow researchers, that characterization exemplifies what they describe as his tendency to condemn -- or in this case, to misrepresent -- the views of those with whom he does not see eye to eye. While the center does support social-norms research, it is best known for the very environmental approaches that Mr. Wechsler promotes: the creation of campus and community coalitions to develop strategies for reducing student drinking problems, on and off-campus.

“So long as he continues to insist that everyone agree with him about everything, he will remain a divisive force in our field, which we can ill afford,” says William DeJong, the center’s director and a former colleague of Mr. Wechsler’s at Harvard.

Mr. Wechsler’s book also can take a paternalistic tone. In one chapter, for example, the authors urge parents to “model good behavior,” citing the example of a mother and father who gave up their evening glasses of wine for fear that the after-work ritual was giving their college-age daughter the message that drinking is necessary for relieving stress.

In those instances, Mr. Wechsler seems to conflate his message with a strict anti-alcohol stance. Asked if students under 21 are capable of drinking responsibly, he says, “If you go around and say ‘Drink responsibly,’ quite often the part of the message that’s heard is ‘Drink.’ You’re condoning drinking for people for whom it’s illegal.”

“It’s the amount consumed that is a problem,” he continues. “Maturity is an issue. The reason the drinking age exists is that underage drinking and excess go together. There is the issue of inexperience and judgment about things, about drinking. They’re so new at so many things and can cause greater harm.”

Yet some students say that that inexperience -- and the fact that drinking laws are largely meaningless on campus -- is precisely why alcohol education, including programs that teach students how to drink in moderation, are so crucial.

“Informing students and making sure they’re educated, that’s paramount in dealing with this issue,” says Jaime Haak, a senior who is a peer-health educator at the University of Illinois at Urbana-Champaign. “Older students who are of legal age are more likely to be mature drinkers. That reinforces that we should be targeting ... students who have no drinking history, to recognize what responsible drinking is. No one can deny that people under 21 are going to drink.”

Back at the Kells bar, as the Thursday-night crowd filters in, at least two things appear certain: Many students will find a way to drink, and Mr. Wechsler will not abandon his mission anytime soon.

Pointing to an adjoining room where a red-and-blue disco light is blinking, a waitress mentions a brawl that took place the other night.

“It was just crazy,” she says, laughing.

Asked to describe the kinds of students she tends to serve, the waitress shrugs.

“I don’t know,” she says. “I just get ‘em drunk.”

Mr. Wechsler shakes his head: “It doesn’t take much.”

http://chronicle.com Section: Students Volume 49, Issue 11, Page A34