Education and persuasion strategies are popular with policymakers, governments and the public, but are they the answer to hazardous alcohol problems in our communities? Mark Price talks to the University of Otago's Prof Jennie Connor in our Booze Control: Stop and Think series.
Given the key to potential alcoholic oblivion at age 18, how are they to learn the secret to drinking in moderation?
Well not through well-intentioned educational programmes.
That view belongs not only to University of Otago professor of preventive and social medicine Jennie Connor but also to another authority - an 18-year-old target of such programmes.
A. says she learnt her first alcohol lesson at age 16.
It came not from a lecture or a PowerPoint presentation but from an unpleasant experience.
Island-hopping in Fiji, she tried a wine, then a rum, then a whisky, then a vodka, then something else ... and the consequences taught her not to mix her drinks.
Since then, she has learnt other alcohol lessons the same way, by hands-on experience.
''Like anything, it takes practice to figure out what you can handle,'' she says.
So, a night out now might start with a vodka or two or three at home - commonly referred to as ''pre-loading'' - followed by some bar-hopping in town with friends.
She might buy a drink or she might not.
A $34 bottle of vodka will last her at least a month.
Her friends, she says, have all got to a similar point with alcohol - bar one who ''always gets way too drunk''.
She recalls the ''many people'' who came to her high school to educate them about alcohol.
She considers they were, in the main, wasting their time.
''The people who get really smashed every weekend don't really listen to anyone about anything.''
''I honestly think it's a bit of a joke if people think they are going to educate them.
''People learn by themselves. I don't think there's any way you can set up a system to teach them.''
Prof Connor does nothing to rebut this view.
Prof Connor has a long-standing research interest in alcohol-related harm and is aware of the things that have been tried to reduce harm - the things that have worked, and the things that have failed.
She says ''education and persuasion strategies'' are popular with policymakers, governments and the public ''because it seems to make sense''.
''The problem with them - they don't work. There's no evidence that they work.''
And, that, she says, is an ''international consensus'', based on research done on thousands of educational programmes.
She agrees ''absolutely'' with A. and finds her assessment ''insightful''.
Prof Connor says educational programmes raise awareness there is a problem with alcohol.
''And they have no effect on behaviour.
''Even some of the programmes that show a modest amount of effect on drinking in the short term, it doesn't last.
''There is no evidence of any sort of education programme that produces a real change in hazardous drinking or harm.''
Prof Connor says education does not work for smoking, eating fast food or any kind of health behaviour.
Where education can be useful, she says, is in ensuring people know the rules and the punishments.
It is worthwhile, for instance, to inform people that if they drink and drive they might be stopped and breath-tested.
Prof Connor says while those with the biggest alcohol problems are over 30, students are the heaviest drinkers.
Students are well-educated about the dangers of alcohol but that ''doesn't make any difference to their behaviour, except probably for a few individuals''.
A. recalls one lesson she received, on the detrimental effects on the brain, which did lead her to give up drinking for the four months before her final NCEA exam.
Prof Connor believes if New Zealand is to reduce the harm done by alcohol then it needs regulations to rein in the alcohol industry - things like a reduction in the number of pubs and earlier closing times for on-licences.
''There is plenty of good evidence that if you close on-licences, pubs and stuff, earlier, you have less crime.''
And she is an advocate of more tax on alcohol to make it more expensive.
''There's absolutely no doubt, putting the price up reduces consumption, reduces the consumption even of the very heavy entrenched drinkers, it certainly reduces consumption by young people, it reduces the amount of physical health harm and it reduces the amount of violence and disorder.
''And it doesn't cost much to do.''
Prof Connor believes the generation that liberalised alcohol laws has let the country's young people down.
''The chronic heavy drinkers are all older. These are the people young people are learning from. They see it's OK to drink large quantities of alcohol.
''They see it in the supermarket. It's cheap and accessible.
''And we just put them in this situation and they just respond to it in the way that anybody would.''
''To just saturate them with a cheap supply of alcohol and no real disapproval from their families and so on, just expect them to behave in a sensible way - it just doesn't make sense really.''
''You teach them things and then they go outside the door and they are back where they were, surrounded by that environment.
''It's the environment that causes the problem ...''
Saturday: University of Otago stands up.
Advice for parents
Is giving young people a glass of wine with their dinner a good or bad way of teaching them about alcohol?
''It's a bad thing,'' says University of Otago professor of preventive and social medicine Jennie Connor, without a moment's hesitation.
''There is an idea that introducing your kids to alcohol early is a good thing because that's what they do in France and in France they don't have a drinking problem.''
But, she says, France has ''very serious drinking problems''.
And, New Zealanders, she says, are more likely to follow British and Scandinavian drinking habits anyway.
''When you liberalise the law, people just drink more. They drink heavily and in a very messy way.''
She believes the healthiest approach parents can take is to delay ''as long as possible'' their children's introduction to alcohol.
Prof Connor says one of the biggest effects on adolescents is the way their parents drink.
''If you really care about your kids drinking, then you should never allow them to see you drunk.''
