STATEMENT OF DR. JEFFREY W. LINKENBACH
ON BEHALF OF MONTANA STATE UNIVERSITY’S MOST of Us CAMPAIGN TO THE COMMITTEE ON DEVELOPING A STRATEGY TO PREVENT AND REDUCE UNDERAGE DRINKING

THE NATIONAL ACADEMIES’ RESEARCH COUNCIL AND INSTITUTE OF MEDICINE-WASHINGTON, D.C.
November 2002

Thank you Mr. Chairman and members of the committee for allowing me the opportunity to address you on this critical issue of preventing and reducing underage alcohol use. My name is Dr. Jeff Linkenbach. I am a research faculty member at Montana State University, and the Director of the Montana Social Norms Project. I speak to you today however as an academic, a practitioner, and a certified chemical dependency counselor who has been in the trenches of community substance abuse treatment and prevention for the past 17 years, and who has a passion for focusing on what works.

Through my hands-on prevention work with teens, college students and communities, I have become frustrated with the “institutional insanity” of implementing the same prevention programs year after year with a lack of evaluation data. This frustration has led me to search for an effective strategy to address issues such as the reduction of youth drinking.

Traditional prevention programs, which often ignore sound educational theory, are typically based upon various forms of fear tactics that are creatively designed to scare the health into youth target populations. After being involved with numerous projects that lack outcome data, I became tired of developing media and giving lectures which were cleverly disguised ways of telling young people something that they know all too well — there are many different ways that alcohol can kill them. In fact some of my research on a statewide population of 18- to 24-year-olds has implied that by exaggerating and focusing on risk behaviors, prevention programs might actually be increasing those very risk-taking behaviors that they seek to mitigate by distorting perceptions of what was actually occurring. Hence, I began to explore a counter-intuitive solution, which went beyond scare tactics, and instead sought to use science and positive messages as a way to market and measure increases in health.

I also began to shift the focus of my efforts away from merely targeting individuals with risk-based information, and instead began targeting the larger social and cultural environment in which youth drinking or other risky behaviors occurs. I stopped asking the question, “Do we have youth at risk?” and instead began asking the question, “Do we have youth living in risky environments?”

The importance of focusing on the larger environment — including policies, the availability of alcohol, the role of the media, and peer and community influences — that can encourage or discourage the use of alcohol by people under the age of 21 is well documented, and has resulted in millions of dollars of efforts aimed at affecting positive changes in youth drinking behaviors. Unfortunately, with the recent increased popularity of interventions aimed at increasing youth drinking laws, restricting the availability of alcohol and increased enforcement and punishment, government agencies seem to be ignoring perhaps the greatest science-based tool for addressing the issue of underage drinking—which is the social norms approach to prevention and the vital role of perceptions.

Social norms theory states that much of people’s behavior (especially youth), is influenced by their perceptions of other peoples’ behaviors and attitudes. However, all too often these perceptions are incorrect. If unhealthy behavior is perceived to be “normal” in a group, the social urge to conform will negatively affect the behavior of that group. Alternatively, by changing the messages that come from the environment and educating a target group about positive behavior and attitudes that are in fact the true norms for the group, members have a reduced “peer pressure” to conform to the false norms. The existence of such widespread misperceptions of norms is well documented, for example youth thinking there is much more acceptability and alcohol use occurring than is actually the case. So too are some of the studies demonstrating reduced drinking among youth by using media and other messages to communicate the true norms.

I and my staff at MSU have come to call our campaign the MOST of Us Campaign because we market the positive, protective attitudes and behaviors of the majority of teens as a way to correct misperceptions and alter behaviors. In collaboration with Dr. Perkins, we have documented statewide misperceptions of underage drinking norms and are involved with a study to reduce impaired driving across Montana. Additionally, we have measured misperceptions in other populations and with other behaviors. Examples include, how parents misperceive the protective parenting norms of other parents; how adults under-perceive seatbelt use; and how youth misperceive the rate of tobacco use by their peers. We have been involved with various controlled interventions to impact these health issues at the statewide level with very promising results that have application to this committee.

For example, although alcohol is not tobacco –we have conducted a controlled study where we conducted a social norms intervention in 7 counties and then used the remaining 49 counties as controls. After an 8-month campaign, we measured a 41% difference in the first time smoking rate of teens in the intervention versus control sites. Although different substances, this common objective of youth abstinence should be included for further study of reducing youth drinking.

Clearly underage drinking is a well-documented issue where the use of alcohol by minors is serious, illegal and complex. The solution to the issue of underage alcohol use must go beyond legal restrictions in order to also address the social context in which this risky behavior occurs. We must move beyond the paradigm of launching a war on youth drinking, and instead work with and build upon the positive (norms) and youth cultures that already exist amongst our youngest citizens. We must utilize the science-based, positive strategy known as the social norms approach to prevention as a foundational tool in our efforts to reduce this problem.

Thank you for the opportunity to speak to you today.