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 toEssential
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,
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
What influenced your focus on 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. 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
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
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
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
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
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
View an interview with
Henry Wechsler featured in this Special Topic of
Keywords: heavy drinking, college, contextual influences,
social development, drinking patterns, student groups, sports,
comprehensive intervention/prevention methods.