Reading an interesting piece in The Conversation last month on drinking and regret, I started thinking about how discussions of alcohol and public health policy often seem to misunderstand the nature and attractions of drinking and drunkenness. There’s a tendency to impose a particular view of the world as if it’s objectively ‘rational’ when in fact it’s just one set of personal preferences about what activities are fun, and what level of risk is acceptable.
We’re unlikely to develop policy that is effective and welcomed unless we have a good understanding of what people do and why, and we should reflect carefully on whether it’s reasonable to want to change someone else’s behaviour.
I suggest that trying to understand people’s drinking by using models of ‘planned behaviour’ that identify outcomes as ‘good’ or ‘bad’ misses the point of much drinking, particularly in the ‘night-time economy’. People are specifically seeking out an experience that isn’t planned or rational, that doesn’t fit with everyday (or daytime) norms. Some discomfort and unplanned outcomes can be part of the thrill of a night out.
I suggest that as we approach alcohol policy we can learn from the parallel field of illegal drugs, where harm reduction approaches encourage practitioners to ‘meet people where they’re at’. Similarly, policymakers should meet ‘binge’ drinkers where they’re at, and acknowledge how they actually think and behave.
Drinking isn’t rational
I don’t want to single out that particular article, but it offers a useful starting point. The authors note that fear-based campaigns don’t work well to change people’s drinking behaviour, and they observe that regret isn’t a great motivator for people. They state: “even when young people thought they would regret what they did when drunk and made plans to drink less, they still ended up drinking the same amount.”
Interestingly, despite the talk of ‘generation sensible’ over the past few years, this rings true from my research conducted back in the late 2000s. Plenty of people I spoke to made various plans that evaporated later in the night – for example, one person always set aside a ‘secret’ £10 note for the taxi home, but every week ended up spending this on more drinks and then walking home.
The authors talk about a distinction between regret about things you have done, and regret that you haven’t done something, and suggest that fear of missing out (FOMO) might be a better predictor of drinking behaviour than fear of negative consequences if you do drink. As they put it: “Young adults are more worried about missing out socially than about the hangover the next day.”
Drinking as neither good nor bad
There’s certainly something social about much drinking, especially the kind of heavy communal drinking being studied in this research. But to my mind, this framing of the decision presents a good/bad binary that doesn’t reflect how most people think about these kinds of nights out – and arguably life in general. Even if people express some kind of ‘regret’ in relation to certain drinking decisions, the picture is far from black and white. Mistakes or regrets are often equally as well understood as ‘funny stories’.
This isn’t just a convenient re-branding of an event to avoid any associated shame; the funny story is part of the whole attraction of a night out. The environment and behaviour on certain kinds of nights out is about things being different from the everyday.
There’s lots of good academic work on how different drinking practices are associated with different times, places and occasions, like this from Fiona Measham, or the work of Abdallah Ally and others at the University of Sheffield. For our purposes, think of the music and lighting in a nightclub, the cramped and sweaty atmosphere. Put simply, people willingly put themselves in settings and situations on a Saturday night they might actively avoid on a Tuesday afternoon.
But this isn’t just about a contrast between Tuesday and Saturday types of fun. I want to suggest that not all our apparent pleasures and desires are straightforwardly rational or positive, even to ourselves. In fact, we’re often fundamentally ambivalent about things we seem to enjoy doing. Activities can be risky and fun, uncomfortable and desirable. And crucially, you can make a rational decision to become irrational (intoxicated).
Even ‘the hangover the next day’ isn’t understood as simply negative; it’s part of the ‘time out of time’ that drinking offers, and some might see those who actively avoid a hangover as not really entering into the spirit of things (weak pun intended).
Drinking as an uncomfortable carnival
In my research I used the term ‘carnivalesque’ to describe the unusual behaviour and ambivalent feelings around drinking. This draws on various interpretations of medieval carnival – which wasn’t a simple, joyous experience; there was bullying, violence, dirt and excess, all bound together by semi-observed ritual processes. Think less of the local Rotary Club designing a carnival float and more of the Wicker Man or Midsommar. Other researchers have used the same phrase, or similar alternatives such as effervescence.
Given this ambivalence, if we approach thinking about drinking in terms of weighing ‘good’ things against ‘bad’ – as in the suggestion that “for many young people, the fear of missing out on the good things they might experience while drinking outweighs the fear that they might do something they regret” – we’re probably simplifying and misrepresenting how people actually understand the world and make decisions. The article that prompted me to start thinking about this is based on a theory of planned behaviour which may be useful as a framework – but primarily to illustrate that much behaviour is unplanned, or does not fit with people’s stated intentions.
How we can learn from harm reduction
If we are to create reasonable, effective policy, we need to understand people’s actions and worldview. The authors of the FOMO paper suggest that young people “downplayed the severity of the things they’d done while drunk”, but it seems to me this imposes their own value judgements onto other people. It’s not clear that the actions they mention – such as someone getting a tattoo of a footballer on their bum – are objectively ‘severe’ or even definitively negative.
In these discussions we can perhaps learn something from an approach more common in supporting people who use illegal drugs: harm reduction. This is often referred to as ‘meeting people where they’re at’. This approach doesn’t tell people not to use drugs because they’re immoral or illegal, or emphasise that there’s a ‘better’ way of living. Rather, it starts with identifying what the person using drugs themselves accepts is an undesirable outcome – a ‘harm’ – such as contracting a blood borne virus like Hepatitis or HIV. Having recognised some common ground, the intervention is then to take practical, realistic steps for that individual to reduce their own risk – such as not sharing injecting equipment, by providing plenty of sterile kit.
So FOMO might be why some people drink more than (they say) they intended to, but in terms of what should be done about this, we should start with identifying an agreed harm (not necessarily tattoos of footballers), and consider how we can work with the grain of how people already think and behave.
To give an example at an individual level, think back to my research and you could agree that walking home late at night is risky and no real fun, even for a story later, so rather than always spending the ‘secret’ tenner, that person could start from an honest perspective of how much they might want to drink (possibly including that ‘extra’ £10) and aim to actually have the money available – and use it – to get a taxi home.
I think you can apply the same principles to advocacy and policymaking. We should be focusing on the actual harms we can agree on, rather than seeking to promote one particular way of drinking or behaving that might look more like a personal, almost aesthetic choice.
Written by Dr Will Haydock, former academic researcher and Executive Director of Collective Voice, writing from a personal perspective.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.