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Underage/College Drinking - November 2008
Interview Date: December 2008
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Nelson Toben Nelson
From the Special Topic of Underage/College Drinking

In our Special Topics analysis on underage drinking, the work of Dr. Toben Nelson ranks at #5, based on 19 papers cited a total of 727 times. According to Essential Science IndicatorsSM from Thomson Reuters, his record includes 22 papers, mostly classified in the field of Social Sciences, cited a total of 746 times between January 1, 1998 and August 31, 2008.

Dr. Nelson is an Assistant Professor in the Department of Epidemiology and Community Health at the University of Minnesota's School of Public Health.


In the interview below, he talks with ScienceWatch.com about his highly cited research on college drinking.

 Would you tell us a bit about your educational background and research experiences?

I studied psychology and physical education at Hamline University in St. Paul, MN, and got a Master's degree in Kinesiology at the University of Wisconsin-Madison. During this time, I became more and more interested in health and how environmental conditions, including policy, and social factors, such as income, education, and opportunities available through socioeconomic position, shape the behaviors that influence health.

"There is a very clear pattern in our college student data that students who either participate in intercollegiate athletics, or who are sports fans, are more likely to binge drink."

Those interests led me to my doctoral studies at the Harvard School of Public Health, where I trained as a social epidemiologist. In addition to my academic training, for 12 years I managed a variety of research projects at Harvard on motor vehicle safety, substance use, nutrition, and physical activity.

 What influenced your focus on college drinking?

Heavy drinking in college is an interesting problem that leads to a range of bad social and health outcomes and is strongly influenced by specific contexts. As a group, college students are among the heaviest drinkers in the US population. But we also know that drinking behaviors vary widely by type of student and the type of college that students attend.

I'm very interested in understanding those contextual influences and trying to figure out ways to shape positive environments to improve health. I believe that many of the factors that lead some college students to drink heavily and that compromise their social development and physical health are modifiable. The big question facing us now is how to effectively implement those changes.

 Just how big of a problem is alcohol on college campuses?

I think heavy drinking is probably the leading public health problem facing college students. Nearly one in three young people in the US attend college. We know that heavy drinking is widespread among certain groups of college students and that it can directly lead to some pretty serious consequences, including academic failure, physical and sexual assaults, unintended sex, vandalism, overdose, and motor vehicle crashes. These consequences can be devastating to students and their families and have long-term effects throughout their lives.

College is a unique time in a young person's life—one in which they are socially vulnerable because of loosening their longstanding social ties to family, friends, school, and other organizations like church, and entering new environments where they have few strong ties.

Unfortunately alcohol helps facilitate some new ties and it is marketed to students specifically on that basis. College is also the training ground for our future leaders. We should be figuring out ways to create positive, healthy environments to support their development.

 One of your papers in our analysis is the 2005 Am. J. Public Health paper, "The state sets the rate: the relationship among state-specific college binge drinking, state binge drinking rates, and selected state alcohol control policies." Would you talk a little bit about this paper and your findings?

Drinking by college students is a phenomenon that is often considered from the perspective of the individual drinker, and therefore the interventions to address heavy drinking have focused primarily on individual attributes. Our research really has looked at patterns of drinking across groups of students, and when we do that some interesting findings emerge.

We found that there are different patterns of drinking by college and also by state. Some colleges have higher levels of drinking than others. The same is true among adults in some states; some states have higher levels of binge drinking among adults. We worked together with researchers from the Centers for Disease Control and Prevention and linked their data on drinking among adults with our college data by state.

We found that the states where more adults engage in binge drinking tended to be the same states where more college students engage in binge drinking. We went a step further and found lower levels of binge drinking appeared in the states that had a more comprehensive set of alcohol control policies. The same conditions appeared to be influencing both college student and adult drinking.

 Several of your papers focus on drinking and college athletes or sports fans. Would you say these particular social groups drink more than other groups in college?

"Heavy drinking in college is an interesting problem that leads to a range of bad social and health outcomes and is strongly influenced by specific contexts."

There is a very clear pattern in our college student data that students who either participate in intercollegiate athletics, or who are sports fans, are more likely to binge drink. This was true for both male and female students, and there are not differences in drinking behavior between the athletes and the fans. We also found that at colleges where there are a lot of sports fans, the binge drinking levels tend to be higher, even among nonfans. Interestingly, when you look among athletes in high school, they aren't different from nonathletes in their drinking behavior. There appears to be something about interest in sports that is associated with heavy drinking when a young person enters the college years.

Another group of students who drink heavily are fraternity and sorority members. These are the social centers of many college campuses, and drinking has been a focal point of that socializing.

 How well do prevention/deterrence efforts work in terms of college drinking? Does any one method work better than others?

Very few prevention efforts are effective by themselves—in any area, not just alcohol use. Heavy drinking is a complex behavior that is influenced by lots of factors. To effect change, it will require many different tactics. My own view is that the effective interventions are those that change the conditions that influence everyone's behavior.

Making it just a little bit harder to obtain and consume alcohol appears to be a common theme across interventions that have documented efficacy. But we should not be in the business of arguing the relative merits of this approach vs. that approach. There are so many false dichotomies out there. We need to figure out how to implement a comprehensive set of interventions and move forward. I would argue that comprehensive approaches must include changing the environment.

 What would you like the "take-away lesson" about your research to be?

I think our research has really pointed to the importance of the conditions that exist in the environment and make alcohol more available. It also suggests that it is important to adopt a perspective that focuses attention on larger groups of people or populations, not just consider the problem from an individual perspective. My hope is that those observations will encourage key stakeholders to try and effect change in their environments. Then we can evaluate those changes to see how well they were implemented and to see if they make a difference.

Toben F. Nelson, Sc.D.
Epidemiology and Community Health
School of Public Health
University of Minnesota
Minneapolis, MN, USA

Toben Nelson's current most-cited paper in Essential Science Indicators, with 299 cites:
Wechsler H, et al., "Trends in college binge drinking during a period of increased prevention efforts—findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001," J. Amer. Coll. Health 50(5): 203-17, March 2002. Source: Essential Science Indicators from Thomson Reuters.
Additional Information:
  View an interview with Henry Wechsler featured in this Special Topic of Underage/College Drinking.

Keywords: heavy drinking, college, contextual influences, social development, drinking patterns, student groups, sports, comprehensive intervention/prevention methods.

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Special Topics : Underage/College Drinking : Toben Nelson