A more fluid approach to drinking

Might a consideration of fluid/transient 'drinking styles', alongside traditional harm-focused approaches, be the key to understanding young adult drinking practices?

If you're old enough, think back to the start of the millennium. In many developed countries, this was when drinking among young adults (around 18 to 30 years old) peaked. The period came to be associated with 'cultures of intoxication' – a term denoting the increased social visibility/acceptability (and, from an alcohol industry perspective, profitability) of alcohol consumption and drunkenness as a central feature of typical leisure time activities for many young adults (Measham & Brain, 2005).

But then something changed. Over the last decade international research studies have shown a significant reduction in alcohol consumption among young adults since the early 2000s (e.g. Raninen et al., 2014; de Looze et al., 2015). For example, Swedish survey data indicated a sharp decline in alcohol consumption among 17- to 18-year-old students of both sexes between 2004 and 2012 across drinkers of all levels of consumption (Raninen et al., 2014). Rates of heavy episodic drinking or 'binge drinking' have declined, numbers of individuals who self-define as light-/non-drinkers have gone up, and people first consume alcohol at a later age (Livingston, 2019).

What changes in society might account for these trends? The socio-economic climate of constraint and austerity may have been instrumental in delaying traditional markers of adulthood and independence, such as leaving the parental home, leading to decreased levels of alcohol consumption (e.g. Pape et al., 2018). But on the other hand, living with parents, and having increased disposable income and delayed commitments (e.g. mortgages, marriage) has previously been associated with increased harmful levels of alcohol consumption. Greater recognition of the role of alcohol – both as a negative factor in mental illness, anxiety and depression, and as a positive factor in socialising and social bonding – may influence changing trends in young adult drinking (see Caluzzi & Pennay, 2019). And the role of new technology in reducing alcohol consumption among young adults is also a consideration. Constant access to friends and family via the internet, social media, and cheap mobile devices may have reframed the opportunities traditionally afforded by alcohol as a means for young adults to meet, engage, become intimate, and develop meaningful friendships or social networks with each other.

Then there are attempts to regulate the industry, such as the 'Beer, Wine and Spirits Producers' Commitments to Reduce Harmful Drinking', agreed in 2012 by 12 dominant producers of alcohol drinks (though doubts persist about the success of these efforts to raise corporate social responsibility; see the Institute of Alcohol Studies, 2018). Health discourses around drinking and non-drinking behavior have changed: consider the popularity of 'temporary abstinence initiatives' involving cessation from particular substances, most commonly alcohol, for a full calendar month. 4.2 million people planned to take part in Dry January in the UK in 2019 (British Liver Trust, 2018).

These changes in alcohol consumption among young adults, and the shifting cultural context, are mirrored in the growth of new ways of considering their drinking practices within the world of psychological research. There's an increasing interest in studying moderate, light and non-drinking practices among young adults, who may (or may not) self-define as a particular 'type' of drinker (e.g. as a non-drinker). Such studies have revealed pressures among British university students to deploy various strategies to 'fit in' during social occasions involving high levels of alcohol consumption, including pretending to drink alcohol and taking care to refuse alcoholic drink offers in ways which will not exacerbate peer ridicule or pressure to drink alcohol (Conroy & de Visser, 2014; Herring et al., 2014; Piacentini et al., 2012). Research into beliefs about hypothetical non-drinking during social situations among undergraduates who regularly drink (Conroy & de Visser, 2018) has suggested that many would endorse non-drinking to bolster physical and psychological health and save money but also to generate a stronger sense of self-esteem, stability and productivity in life. However, participants in this study also acknowledged drawbacks to social non-drinking, including concerns about social inclusion.

This broader consideration of drinking practice among young adults has helped recalibrate the research agenda, putting evidence of diverse, diverging and transitional drinking practices alongside a more traditional focus on drinking practices linked to harm and excess. But understanding what these changes mean for longer term drinking patterns is difficult. Young adults may drink less for many reasons, and greater awareness of health risks involved in consumption over the lifespan may help explain these trends of lower levels at an earlier life stage. Is young adult drinking different to drinking at other life stages?

Emerging adulthood

Young adults face pressures spanning various domains of life: deciding on living arrangements and lifestyle choices; deciding whether to embark on Higher Education studies; securing meaningful, sustainable employment; accessing licensed leisure in adult night life and festival economies; initiation and experimentation with illicit drugs and altered states of intoxication; identifying whether and what relationship circumstances suit an individual; and similar issues relating to choices and meanings associated with identity and sexuality. These pressures are not, of course, unique to the 18-30 age group, but the breadth and novelty of these pressures, many of which will be experienced for this first time during this life period, arguably mark 'young adult' alcohol use as something that occurs in the context of a constellation of demands and volatility.

The unique status of young adulthood as a distinctive life stage suggests that there may be much to learn from a research and policy perspective by focusing on the varied drinking practices, whether changed, changing or enduring, among this demographic group. More specifically, Jeffrey Arnett's (2000) account of 'emerging adulthood' has been useful in distinguishing young adulthood from being an 'adolescent' or 'young person' and from being subsumed within the more sprawling category of formal 'adulthood'. Focusing on this distinctive cohort therefore makes sense from both research and policy perspectives, giving rise to health-related studies in the emerging adulthood literature (e.g. Arnett, 2005; Maynard et al., 2015).

Through this lens, we can consider cultural understandings of what becoming and 'being' a young adult could or should entail. Alcohol retains visibility and importance as a symbol of 'being young', and the alcohol industry recognise and capitalise on this symbolic power in specific settings (e.g. hospitality, festival industries) and in marketing strategies (Hastings et al., 2010). Alcohol branding and sponsorship have a significant presence in young adult leisure – evident in the naming of entertainment arenas, live music stadia and festival bars – despite growing restrictions on sponsorship of sporting events and of alcohol marketing more generally in many developed countries (Rowley & Williams, 2008).

In such an environment, young adults may put early experimentation with alcohol behind them. But many young adults leave the protective influences of family and local community when they commence Higher Education studies or begin first jobs, and these experiences of alcohol may guide alcohol's role for the rest of that individual's life. Whilst empirical reviews have focused on normative education and enhancing social and social resistance skills as effective prevention programmes for secondary school youth, more consideration is needed regarding the kinds of interventions that might be most appropriate for young adults (Botvin & Griffin, 2007). Could 'drinking styles' be the key?

The language of drinking

The language available to describe drinking behaviours and practices, and for identifying drinker 'categories', is vast (and growing). How the press and the public talk about drinkers and drinking is deeply entrenched in distinct cultural and historical settings, and this is reflected in, and perpetuated by, academic writing on the subject of alcohol consumption.

For example, young adult alcohol consumption might be understood in terms of 'social drinking', 'moderate drinking', or, less favourably, in terms of 'problem drinking', 'anti-social drinking', or, perhaps most (in)famously, 'binge drinking'. Changing trends in alcohol consumption among young adults may mean that terms like 'non-drinking', or 'light drinking', have wider exposure, or greater social legitimacy than has previously been the case. Related terms invoke moral positions on alcohol consumption as a cultural activity, illustrated in terms like 'risky drinking', 'harmful drinking', 'immoderate drinking' and, increasingly visibly, the terminology of 'responsible drinking' in a range of international settings (e.g. International Alliance of Responsible Drinking, 2019).

These drinker categories and terms to emphasise particular features of drinking behaviour set boundaries around how drinking behaviour among young adults might be understood in terms that are relatively more or relatively less morally acceptable, harmful to the self and harmful to other people. Moreover, these categories and terms are frequently used as core starting points of alcohol research, evident in how research questions are framed, in how research projects are designed and implemented, and in terms of how research evidence is used to rationalise the development and delivery of alcohol policy and clinical interventions relevant to alcohol consumption.

Time and again, research illuminates the complexities and contradictions involved in drinking practices among young adults. For example, ongoing interview research conducted by Conroy, Morton and Griffin (2020) reveals that drinker categories like 'binge drinker' have widely differing meanings among different individuals and that formal definitions of categories like 'binge drinker' and 'light drinker' are, similarly, used in strategic ways by young adults to protect against potential stigma surrounding too much (or too little) alcohol consumption. Stigma linked to non-drinking has been demonstrated as pervasive in empirical work conducted among UK undergraduates – where 91 per cent of 493 respondents reported more unfavourable views of the prototypical non-drinker relative to the prototypical drinker (Conroy & de Visser, 2016). Qualitative research supports the impression that non-drinking university students may frequently encounter stigma linked to their decision to abstain from alcohol consumption (Conroy & de Visser, 2013; Jacobs et al., 2018).

As useful as these 'drinker category' terms may be in academic and everyday language as shorthand, they can create a decontextualised and coarse understanding of how, when and why young adults choose to drink alcohol. In our newly published edited collection, Young Adult Drinking Styles, we argue that the term 'drinking styles' has theoretical and real world advantages as a framing device for changing trends. A typical individual's drinking practices are likely to vary within and between drinking occasions, different environments and life stages. From a theoretical perspective, recording changes within and across drinking episodes (or any other time-related trajectory) can produce a more accurate and meaningful account of where and when higher levels of alcohol consumption may be likely to occur, but also help to highlight and map evidence of resilience to drinking motivations or peer expectations to consume alcohol during social occasions.

The notion of 'styles' in the context of health behaviour or practices is rare. We don't conventionally talk in the applied health promotion literature of 'eating styles', 'styles of sexual practice', 'physical activity styles'. This is perhaps surprising given the prominence of styles amongst educationalists, in terms of learning (an area not without controversy). Drinking styles is not a new term, however. It has appeared in discussion of patterns of drinking behaviour among individuals with a diagnosis of alcoholism and the children of alcoholics (e.g. Johnson et al., 1989; Olenick & Chalmers, 1991), and is present in the work of Betsy Thom and colleagues in documenting the nuances in young men's motivations to drink and their drinking practices (Harnett et al., 2000). There's also work on 'peer attachment styles' (Bartholomew & Horowitz, 1991) and 'romantic attachment styles' (Hazan & Shaver, 1987) in young adulthood, and it is from these studies that we have drawn inspiration.

In practical terms, 'drinking styles' provides a term that recognises that drinking behaviour is chosen and re-chosen between and within events involving the potential for alcohol consumption. It acknowledges that a young adult has possibilities open to them in terms of how they understand the role of alcohol, its subjective effects, its social role and its community and cultural understandings. But, how, in practical terms, might 'drinking styles' be employed as an alternative concept or form of measure used in alcohol research?

There are no easy solutions to this question. But producing a more nuanced, complex impression of how young adult drinking styles work is likely to draw on more complex designs and methodological approaches than is often the case in social science research. For example, N-of-1 research programmes involving regular and numerous quantitative measures present a powerful tool for understanding the minutiae of drinking practices within pre-defined time frames. The flexibility and sophistication of this approach has been underscored in substance use studies (e.g. Ridenour et al., 2009). Qualitative research provides other ways for exploring drinking styles. Interview research demonstrates how people actively reject being understood in terms of (stigmatised) drinker categories (Banister et al., 2019). And research highlights the significant role of personal agency in young adult drinking practices, emphasising how practices are reflected on and adopted on a situation specific basis rather than in a more enduring/essential sense (Conroy & de Visser, 2015). For example, Conroy and de Visser (2015) reported data that suggested that issues of choice around drinking style, adopted within and between scenarios, were of critical importance to self-defined non-drinkers, as illustrated in the extract below from one participant:
'You know, if someone offers me a drink, I think, "Do I want a drink? Don't I want a drink?", and I, 99.9 per cent of the time I don't want a drink. […] I don't like the idea of being labelled as anything. I am me, I do what, I do certain things, I don't do other things. But I don't want to be labelled by what I do and don't do.' – Michelle

Drinking styles then evokes an understanding of alcohol as something engaged in a wide variability of ways in different settings, in different company and at different stages of the life cycle.

Taking drinking styles forward

Young adult drinking remains hampered with outdated and often unhelpful tropes oriented toward 'binge drinking' and invoking moral panic around the dangers of 'irresponsible drinking'. Hard evidence of changing trends present many options for how research might generate a revitalised, more accurate understanding of current and changing drinking trends among young adults.

Let's finish with a specific context, to illustrate what we think research programmes around young adult drinking should emphasise. Welcome Week (or 'Freshers' week'), before the start of a new academic term for students commencing Higher Education studies, remains closely linked with possibilities for long periods of high levels of alcohol consumption as part of induction to university life. Young adults have suddenly left the relative protections of their family home environment and may experience a dramatic change in their relationship with alcohol. Such shifts may be linked to assumed or real expectations of what constitutes normal alcohol intake among university students, and may have profound implications for future drinking practices and therefore the public health agenda (see Sawyer et al., 2012).

At such a time, as psychologists, we need to know more about reduced alcohol consumption; the variety of ways in which 'drinking styles' as a concept might reframe understanding to draw greater emphasis to the variability and context-dependent nature of drinking practices; and the constructive power of language involved in accounts of drinking shared amongst young adults, researchers, the media and the alcohol industry.

We would be interested to hear, via the contact below or through these pages, how students negotiate Welcome Week in 'drinking style' terms. Certainly the evidence points to the importance of taking care with language involved in discussing socialising in relation to alcohol consumption; for example, refusing drink offers firmly but in a friendly way (Conroy & de Visser, 2014), or encouraging social pastimes that do not involve alcohol as a prerequisite for having fun (Herring et al., 2014). But part of this protective strategy may also involve students seeking to distance themselves from die-cast categorical labelling (e.g. 'binge drinker' but also 'non-drinker'). Such labelling may be instrumental in restricting them to consume alcohol and/or to socialise according to predictable, narrow routines. Instead, young adults can re-imagine their relationship with alcohol, and reconsider available social possibilities at each turn of their daily and weekly schedules.

- Dominic Conroy is a Lecturer in Psychology at the University of East London. [email protected]

- Fiona Measham is at the University of Liverpool.

References

Arnett, J.J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American psychologist, 55(5), 469.

Arnett, J.J. (2005). The developmental context of substance use in emerging adulthood. Journal of Drug Issues, 35(2), 235-254.

Banister, E., Piacentini, M.G. & Grimes, A. (2019). Identity refusal: Distancing from non-drinking in a drinking culture. Sociology, 0038038518818761.

Bartholomew, K. & Horowitz, L. M. (1991). Attachment styles among young adults: a test of a four-category model. Journal of Personality and Social Psychology, 61(2), 226.

Botvin, G.J. & Griffin, K.W. (2007). School-based programmes to prevent alcohol, tobacco and other drug use. International Review of Psychiatry, 19(6), 607-615.

British Liver Trust. (2018). Millions to do dry January 2019. Accessed 17th January 2020 from https://britishlivertrust.org.uk/millions-to-do-dry-january-2019/

Caluzzi, G. & Pennay, A. (2019). Alcohol, young adults and the new millennium: Changing meanings in a changing social climate. In Young Adult Drinking Styles (pp. 47-65). Cham: Palgrave Macmillan.

Conroy, Morton & Griffin (2020). 'From Drunkenness to Relative Sobriety: University Student Accounts of Attempting to Drink Less or No Alcohol'. Manuscript in preparation.

Conroy, D. & de Visser, R. (2014). Being a non-drinking student: An interpretative phenomenological analysis. Psychology & Health, 29(5), 536-551.

Conroy, D. & de Visser, R. (2015). The importance of authenticity for student non-drinkers: An interpretative phenomenological analysis. Journal of Health Psychology, 20(11), 1483-1493.

Conroy, D. & de Visser, R. (2016). Understanding the association between relative sociability prototypes and university students' drinking intention. Substance Use & Misuse, 51(14), 1831-1837.

Conroy, D. & de Visser, R.O. (2018). Benefits and drawbacks of social non‐drinking identified by British university students. Drug and Alcohol Review, 37, S89-S97.

de Looze, M., Raaijmakers, Q., ter Bogt, T. et al. (2015). Decreases in adolescent weekly alcohol use in Europe and North America: Evidence from 28 countries from 2002 to 2010. The European Journal of Public Health, 25(suppl 2), 69-72.

Harnett, R., Thom, B., Herring, R. & Kelly, M. (2000). Alcohol in transition: Towards a model of young men's drinking styles. Journal of Youth Studies, 3(1), 61-77.

Hastings, G., Brooks, O., Stead, M. et al. (2010). Alcohol advertising: The last chance saloon. BMJ, 340, 184-186.

Hazan, C. & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52(3), 511.

Herring, R., Bayley, M. & Hurcombe, R. (2014). "But no one told me it's okay to not drink": A qualitative study of young people who drink little or no alcohol. Journal of Substance Use, 19(1-2), 95-102.

Herring, R., Berridge, V. & Thom, B. (2008). Binge drinking: An exploration of a confused concept. Journal of Epidemiology and Community Health, 62, 476-479.

Institute of Alcohol Studies. (2018). The alcohol industry. Retrieved 13 January 2020 from http://www.ias.org.uk/Alcohol-knowledge-centre/The-alcohol-industry.aspx

International Alliance of Responsible Drinking. (2019). Mission statement. Accessed 17 June 2019 at http://www.responsibledrinking.org/

Jacobs, L., Conroy, D. & Parke, A. (2018). Negative experiences of non-drinking college students in Great Britain: An interpretative phenomenological analysis. International Journal of Mental Health and Addiction, 16(3), 737-750.

Johnson, S., Leonard, K.E. & Jacob, T. (1989). Drinking, drinking styles and drug use in children of alcoholics, depressives and controls. Journal of Studies on Alcohol, 50(5), 427-431.

Livingston, M. & Vashishtha, R. (2019). Have recent declines in adolescent drinking continued into young adulthood? In Young Adult Drinking Styles (pp. 21-46). Cham: Palgrave Macmillan.

Maynard, B.R., Salas-Wright, C.P. & Vaughn, M.G. (2015). High school dropouts in emerging adulthood: Substance use, mental health problems, and crime. Community Mental Health Journal, 51(3), 289-299.

Measham, F. & Brain, K. (2005). 'Binge' drinking, British alcohol policy and the new culture of intoxication. Crime, Media, Culture: An International Journal, 1(3), 262-283.

Olenick, N.L. & Chalmers, D.K. (1991). Gender-specific drinking styles in alcoholics and nonalcoholics. Journal of Studies on Alcohol, 52(4), 325-330.

Pape, H., Rossow, I. & Brunborg, G.S. (2018). Adolescents drink less: How,who and why? A review of the recent research literature. Drug and Alcohol Review, 37, S98–S114.

Piacentini, M.G., Chatzidakis, A. & Banister, E.N. (2012). Making sense of drinking: the role of techniques of neutralisation and counter‐neutralisation in negotiating alcohol consumption. Sociology of Health & Illness, 34(6), 841-857.

Raninen, J., Livingston, M. & Leifman, H. (2014). Declining trends in alcohol consumption among Swedish youth—does the theory of collectivity of drinking cultures apply? Alcohol and Alcoholism, 49(6), 681-686.

Ridenour, T.A., Hall, D.L. & Bost, J.E. (2009). A small sample randomized clinical trial methodology using N-of-1 designs and mixed model analysis. The American Journal of Drug and Alcohol Abuse, 35(4), 260-266.

Rowley, J. & Williams, C., (2008), The impact of brand sponsorship of music festivals. Marketing Intelligence & Planning, 26(7), 781.

Sawyer, S.M., Afifi, R.A., Bearinger, L.H. & Patton, G.C. (2012). Adolescence: A foundation for future health. The Lancet, 379(9826), 1630-1640.