Written evidence submitted by Dr William
Haydock (AG 14)|
1. Government guidelines regarding alcohol consumption
are primarily designed to inform people's alcohol consumption.
Although they must be based on scientific analysis, they should
not be set without reference to their aim in shaping drinking
behaviourand indeed the numerical figures have never been
precise in terms of how they relate to harms resulting from alcohol
use (Nicholls 2009, p.212). The guidelines and associated communication
strategies must be chosen with an awareness of how people may
respond to them. This submission therefore discusses potential
responses of current drinkers to various Government social marketing
2. It is not clear that recent strategies for
communicating guidelines for consumption, exemplified by the Units
and Would You? campaigns, have been effective in altering
young people's drinking behaviour. Some young people actively
seek out the unusual, and apparently undesirableand yet
not criminalbehaviour depicted in the Would You?
advertisements, while others defend their drinking against quantitative
consumption guidelines as communicated by the Units campaign
by reference to the understanding lying behind Would You?:
that behaviour while and after drinking is the measure by which
problematic drinking should be defined, rather than quantity consumed.
3. Therefore, learning from previously successful
campaigns to change norms and behaviour, I recommend that the
setting and communication of alcohol guidelines be shaped by a
focus on demonstrable crimes and harms to the individual drinker
concerned and, perhaps more powerfully, to others around them.
4. I will shortly be taking up a post as Information
and Research Officer for Dorset County Council's Drug Action &
Community Safety Team. However, I write here in a personal capacity
and this submission is based on research and analysis conducted
for my PhD, "Gender, Class and "Binge" Drinking",
awarded by Bournemouth University, available from http://eprints.bournemouth.ac.uk/16236/.
This included analysis of existing Government policy relating
to alcohol, and interviews, observations and focus groups involving
a range of relevant stakeholders: young drinkers themselves as
well as various related professionals from youth workers to bar
staff and managers, as well as local council staff. The names
have been changed of all participants and venues referred to herein.
5. I am not aware of any relevant interests.
The research for my PhD was funded directly by Bournemouth University.
6. The key attempt to communicate specific Government
guidelines on drinking in recent years was the Units campaign
of 2008. This showed the number of units in various drinks, such
as glasses and bottles of wine, pints of beer, and glasses of
gin and tonic, followed by the phrase: "Units. They all add
up." The targeted individual was considered to be 25 or over
(see Home Office and NHS 2008).
7. In tandem with the Units campaign,
the Government ran the Would You? campaign, which aimed
to highlight the possible negative consequences of drinking "excessively",
asking drinkers whether they would undertake a number of actions
if they were sober. These actions ranged from the criminal through
the dangerous to the antisocial or, arguably, simply immoral.
The campaign was organised around the overarching theme "You
wouldn't do this sober". Various posters, for example, advised
drinkers not to smash up a shop, jump in rivers, or urinate in
the street while another, implicitly aimed at young women, asked
whether they would get into a car with a man they had just met
if they were sober.
8. In some cases, the consequences of drinking
that were portrayed as being undesirable in these two campaigns
clearly relate to personal health and safety or committing crimes
against other people. For example, to smash a glass in someone's
face, as one of the Would You? posters envisages, is unquestionably
a crime. Equally, there are undoubtedly alcohol-related health
issues underlying the Units campaign, even if their precise
relationship with the specific recommended consumption limits
may be debatable.
9. However, not all the apparently negative consequences
of drinking envisaged by the Would You? campaign are so
clear cut, and can be seen as resembling something of a moral
A number of actions depicted might be considered "anti-social",
but it is difficult to see who is the direct "victim"
of the transgressionapart from the perpetrator, who might
have their pride or self-respect damaged. This is well illustrated
by the television advertisements for the Would You? campaign.
One shows a young man preparing to go out(NHS and Home Office
2008a), another shows a young woman(NHS and Home Office 2008b);
as they get ready, the man urinates on his shoes, spills food
on his t-shirt and rips his jacket, the woman gets her skirt wet,
smudges her eye make-up and smears vomit in her hair. The adverts
then ask: "You wouldn't start a night like this so why end
it that way?"
10. The actions are symbolic of being excessive
and irresponsible. They are not normal everyday (or daytime) behaviour.
However, it is not immediately clear why the Government should
be concerned with all the actions in the advertisements from a
crime and health perspective. Even urinating on one's shoes or
having a wet skirt are unlikely to cause a health problem, although
the fact that one has vomited suggests that one has drunk more
alcohol than one's body can cope with. This approach sprang from
the conviction that alcohol-related problems originate in a wider
culture surrounding drinking in the UKa conviction that
has been central to both the Labour and the Coalition Governments'
approaches to drinking.
11. Therefore, it appears that there are two
key assumptions behind this approach. First, if the activities
shown are being engaged in, then there is a significant risk of
genuine offences or mistakes occurringalso as a result
of alcohol consumption. Second, a focus on these activities is
a way to shape drinkers' behaviour, as they will be ashamed of
12. This rationale also lay behind Diageo's similar
2007 Choices campaign. However, Diageo understood that
this tactic and campaign was only suitable for targeting those
who do feel ashamed of their drunken behaviourwhich is
a particular group of young drinkers, referred to as "irresponsible
In my research I did not find quite the same groupings as Diageo,
but the point remains that not all drinkers in the night-time
economy have a sense of shame that can easily be mobilised to
change their behaviour, as I discuss in the following section.
13. Many young people drink to get drunk, which
according to recent Government definitions would classify them
as "binge" drinkers (see, for example, Szmigin et al.
2008). I refer to this approach as a "carnivalesque"
drinking style, which one participant, Ollie, explained in very
clear terms, telling me that in order for a night out to be considered
"legendary" something "unusual" must happen,
and this is only really possible if people drink and get drunk.
14. The most striking example of such a "legendary"
story was told to me by Hannah, a first-year university student
reminiscing about a day she had spent drinking when she was 17.
She had gone to the toilet in the pub where she and her friend
had spent the afternoon drinking shots, and was walking back to
her table when her friend came over to her in the middle of the
pub and stopped her. Hannah had walked out of the toilet with
both her trousers and underwear still around her ankles because
she was so drunk. She explained that initially such incidents
can be embarrassing but they can soon become amusing: "You
think "Oh God", and a few, maybe a few months later
on you think "Oh that's really funny", you tell it to
all your friends and they laugh and you laugh." She then
laughed herself, remembering the incident, and, thinking about
it, declared: "It was brilliant though". Importantly,
the day was considered "brilliant" despite the fact
that later in the evening she was sick and fell over a small walland
still bears the scar from the fall.
15. These are precisely the sorts of actions
that were condemned in the Would You? campaign, yet in
Hannah's case are, if not celebrated at the time, considered perfect
fodder for a funny, legendary story later. The incident is not
shied away from or entirely veiled in shame, though the re-telling
of the story may involve negotiating shameful associations. Such
drinkers are deliberately trying to end the night in a different
way from how they started it, in contrast with the Would You?
slogans. Any instruction to avoid certain situations where the
problem or harm is not evident to the drinker is therefore likely,
I suggest, to be met with indifference or frustration.
16. As in the Diageo Choices campaign,
however, such social marketing campaigns are not necessarily targeted
at "carnivalesque" drinkers. In my research I found
that some drinkers reject such celebrations of out-of-the-ordinary
behaviour, and stress instead their difference from those they
see as being mainstream "binge" drinkers. I understand
their approach to drinking using the term "everyday".
17. In terms of alcohol consumption directly,
this everyday approach rejects the idea of drinking to get drunk.
Simon expressed this neatly when he told me "I enjoy a drink,
rather than drink to enjoy myself", and "I drink and
have a laugh" contrasting this with those who drink in
order to have a laugh. He explained that, for him, drink is
involved, but for most other "people today" drink
has to be part of their night out.
18. However, this approach does not imply drinking
within Government unit guidelines. Another participant, Sam, defended
his consumption by suggesting that unit-based definitions of "binge"
drinking are "stupid". He explained that he and his
friends had been drinking in the Rose and Crown since 12.30pm
and it was now about 7.30pm, yet they were not about to "kick
off" despite having "binged" according to, as he
saw it, the Government definition. As far as he was concerned,
quantity of alcohol consumed was irrelevant; what was important
was people's behaviour, and he stated in his defence that he and
his friends were probably the "sanest" people there,
certainly more so than some "18-year-olds" who had had
"a couple of pints of Stella".
19. This is not to say that such drinkers did
not in fact engage in activities that Government might consider
undesirable, quite apart from any potential health damage of drinking
significant quantities of alcohol. Two young men were particularly
vocal in stressing their "difference" from other mainstream,
"binge" drinkers. Nevertheless, one explained with a
laugh how the other had once set fire to public bins in a park
on his way home from a night out. This was told as a funny story,
and was not seen to compromise their position as different from
20. It is therefore not clear that campaigns
of either approachUnits or Would You?will
be effective in targeting those with a carnivalesque or an "everyday"
approach to drinking, disregarding the possible group of "irresponsible
shamefuls" who might be identified and relied upon to respond
in the desired way. Those with a carnivalesque approach will tend
to see many of the criticisms of the Would You? campaign
as unhelpful, and will reject its model of ideal drinking behaviour.
Conversely, those taking an "everyday" approach would
be unlikely to recognise themselves in such campaigns focusing
on apparently out-of-control drinking behaviour as this does not
fit their conceptions of their own behaviour or motivations. At
the same time, the Units campaign seems unlikely to resonate
with these "everyday" drinkers as they choose to define
their behaviour as responsible in terms of behaviour relative
to other drinkers.
21. These criticisms serve to make the point
that where Government has used multiple definitions of concepts,
such as "binge" or "responsible", it is not
always the case that drinkers will take these and use them to
understand and change their own behaviour in the desired way.
The idea of drinking responsibly when considered in terms of behaviour
or motivation is completely at odds with the carnivalesque drinking
style, and cannot be employed to regulate people's behaviour within
it. On the other hand, the definition in terms of behaviour and
motivation allows those within the "everyday" drinking
style to see "binge" drinking as the primary problematic
form of consumption, and their practices as "responsible".
22. One possible response to these problems is
therefore that the concepts should be more clearly fixed and defined.
It could be argued that the Government already has very clear
unit definitions and daily and weekly limits, which have been
communicated through the Units social marketing campaign,
and yet drinkers like Sam still duck the issue. However, Sam was
able to sidestep the Government's unit-based definition of "sensible"
or "responsible" drinking by virtue of invoking another:
the behaviour-based one. Although he had drunk more than the recommended
number of units, he was still drinking "responsibly"
because he was not behaving like a binge drinker, and therefore
he could feel he was referencing legitimate authority to support
23. To some extent, it is difficult to avoid
tensions and alternative definitions of "binge" or irresponsible
drinking, because there are different ways in which alcohol-related
problems can be conceptualised. There are potential long-term
health issues but also immediate harms more associated with "binge"
drinking, as well as other policy issues in the areas of crime
and economics, for example. Nevertheless, I would suggest that
tighter and more consistent definitions and campaigns can serve
to resolve some of these issues.
24. My criticisms so far might be seen as somewhat
counterintuitive or back-to-front. To some extent they suggest
that a campaign to address "binge" drinking should be
shaped by precisely the attitudes that it is trying to change.
However, this approach can be better understood if it is considered
that there are two ways to approach the aims of alcohol-related
social marketing: first, to work within existing norms to make
people manage their desires and behaviour better; second, to change
those overarching norms themselves. The evidence presented here
suggests that recent Government campaigns are unlikely to have
been successful in the first of these aims; I would also suggest
that these campaigns are also unlikely to succeed in the second.
25. When considering previous attempts to change
social norms from a public health perspective, thesuccessfulexamples
of drink driving or, more recently, the ban on smoking in workplaces,
are sometimes cited(eg Stead et al. 2009). Although the cases
differ, with Government in both cases prepared to criminalise
the activities in themselves, the comparison does provide useful
lessons for alcohol policy given that the campaigns, separate
from criminal justice proceedings, have served to make the targeted
practices socially unacceptablean aspiration of Government
with respect to "binge" drinking.
26. One key feature of both smoking in public
places and drink driving is that although both practices place
individuals' own health at risk, this is not the basis on which
either initiative was justified. Rather, the central point was
that drink driving or smoking in someone's workplace can harm
other people, and therefore the state does not consider that individual
drivers or smokers should be allowed to impose this risk on others.
There is no doubt that this argument can be applied to alcohol-related
crimefor some people at least, their drinking-related behaviour
places others at risk. Identifying such a hard-hitting impact
could be a successful way to defuse the implicit criticism of
the Would You? campaign inherent in the carnivalesque drinking
27. Therefore, when communicating the downsides
of certain forms of drinking, I suggest that Government should
focus on those where either the individual themselves or, perhaps
more powerfully, another person is demonstrably harmedrather
than concerning itself with the broader moral health of British
young people, in terms eerily reminiscent of previous "moral
panics". This will also ensure greater consistency across
different definitions and campaigns, as none of the harms could
be easily dismissed. I argue that by condemning a particular drinking
culture the important messages regarding health and individual
safety may become diluted and therefore ignored. If these implications
for social marketing can be summarised in one sentence, it is
that one must be very clear about what the problem is, and who
the message regarding this is being targeted at.
Borsay, P, 2007. Binge drinking and moral panics:
historical parallels. History & Policy, September. Available
[Accessed: 2 October 2008].
Cohen, S, 2002. Folk Devils and Moral Panics: The
Creation of the Mods and Rockers. 3rd ed. London: Routledge.
Haydock, W, 2009. Gender, Class and "Binge"
Drinking: An ethnography of drinkers in Bournemouth's night-time
economy. Thesis (PhD). Bournemouth University, Poole.
Hobbs, D, 2005. "Binge drinking" and the
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[Accessed: 16 January 2009].
NHS, and Home Office. 2008a. Would You? Male TV Advert.
Available from: http://www.alcoholstakeholders.nhs.uk/media/Alcohol_Harm_Reduction_Boy.mpg
[Accessed: 19 January 2009].
NHS, and Home Office. 2008b. Would You? Female TV
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[Accessed: 19 January 2009].
Nicholls, J, 2009. The Politics of Alcohol: a History
of the Drink Question in England. Manchester: Manchester University
Stead, M, Gordon, R, Holme, I, Moodie, C, Hastings,
G, and Angus, K, 2009. Tackling alcohol harm: lessons from other
fields. Joseph Rowntree Foundation. Available from: http://www.jrf.org.uk/sites/files/jrf/alcohol-attitudes-behaviour-full.pdf.
Szmigin, I, Griffin, C, Mistral, W, Bengry-Howell,
A, Weale, L, and Hackley, C, 2008. Re-framing "binge drinking"
as calculated hedonism: Empirical evidence from the UK. International
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22 This is perhaps an overused term but is helpful
in this context. See Cohen (2002) originally, and Borsay (2007)
and Hobbs (2005) on drinking specifically. Back
For an introduction to this campaign, see the "Brief for
Meeting 3" of Responsibility Deal: Working with businesses
to improve Public Health, pp.9-10. Available from http://www.publichealthcommission.co.uk/pdfs/PHCMeetings/NA-Pre-reading.pdf Back
I have discussed the everyday and carnivalesque drinking styles
in more detail elsewhere (Haydock 2009). Back