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01 October 2015

Applying Behavioral Economics to College Drinking

Applying Behavioral Economics to College Drinking

In my retirement I have found time for more reading; I am becoming a student of "behavioral economics" (BE) - see books like Thinking Fast and Slow by Kahneman and Nudge by Thaler & Sunstein. One aspect of BE is the concept of "choice architecture" or engineering the environment so as to offer individuals subtle "nudges" designed to help them make personal choices and behavioral decisions that enhance their quality of life, personal health, social responsibility, etcetera. One such architectural device is "priming."
Priming refers to subtle influences that can affect the likelihood that certain information comes to mind when considering various topics...like whether to drink or not, and if so, how much, how fast, etcetera. By priming students regarding these choices, it is possible to affect the decisions they make. Although there are numerous ways to engage in priming, one way that occurs to me as relatively easy to implement and of possible significance regarding collegiate drinking is to simply ask individuals if they intend to drink and then ask about their plan regarding that intention.

Assume for the sake of discussion that a nurse in the campus health center is conducting a routine interview with a student--it can just as easily be a counselor in the counseling center, faculty member in an advising session, or coach in the athletic center. The presenting issues is unimportant; what is, is that the nurse is conversing with the student. During the conversation the nurse asks, "If you plan to drink during the coming week, how likely are you to moderate use?" Irrespective of how the student answers, the nurse then says, "I'm curious; how do you intend to do this?" NOTE: Authority figures like coaches and faculty members will likely elicit a less than truthful, "I have no plans to drink" response. This is fine...more on "less than truthful" responses in a moment. 
The simple act of asking about intent increases the likelihood that the student will engage in the expressed behavior. This has resulted when asking individuals about their intentions regarding everything from plans to vote, to flossing their teeth, to exercising. To follow the first question with a second that specifically asks about "the plan," causes the student to first, think about "how" to moderate drinking and second, what might that plan look like. 
When routinely interviewing students about drinking, I used to take this a step further and would ask what "moderate consumption" means. Generally, I would get answers like, "3 to 5 drinks." NOTE: Even if this is a lie, the fact that the student defines moderate as "3 to 5" creates dissonance in any consumption that exceeds 5 as it creates an uncomfortable emotional state that students tend to dissipate by acting in accordance with their original statement. I would then give the student 5 cardboard "poker chips" (actually, the were the "holes" from state Liquor Control Board door hangers on blood alcohol level) and instruct students to place these "chips" where they keep keys, cell phone, etc. in their residence.
I then suggested that before going out: (1) ask yourself, "am I going to drink?" (2) if yes, "how many," and then place that number of chips in the dominant-hand pocket, then (3) when having a drink, move one chip from the dominant pocket to another pocket. I would then ask the student, "When you put your hand in your dominant pocket and the chips are gone, what does that mean?" The student generally would say it meant 3 - 5 drinks were consumed. I would agree and then ask, "will that ensure that you will not have another?" Usually, the student would look at me and pause. I would smile and comment that, "no, it does not keep you from having more, but it does ensure that if you do, you will know that you have decided to exceed your own limit for the outing." 
Generally, this conversation ends by discussing the "gimmick" as a simple way to ensure thinking about whether or not one wants to drink before going out and if so, how much. In short, the entire activity was an exercise in priming.
Historically, prevention projects have sought to change behavior by controlling physical environments, increasing awareness about risks and social norms, and utilizing non-invasive conversations with students to invite them to consider their behavior. The point of this post is to suggest that considering BE--with priming being but one example--may enable us to add additional arrows to the prevention specialist's quiver.
What do you think?
Dr. Robert