Alcohol is all but omnipresent in contemporary collegiate life, but reporting this is not news. As early as 1953, Robert Straus and Selden Bacon (1), sociologists at Yale, surveyed the drinking of approximately 15,747 students at 27 U.S. colleges and reported that most respondents reported drinking. However, they noted that relatively few students drank “frequently or heavily” (2). Fast forward to the present, and in December 2015 (3), the National Institute on Alcohol Abuse and Alcoholism suggested that 60% of college students responding to a survey reported drinking at least once in the previous month, with two-thirds indicating the consumption of enough drinks to achieve a blood alcohol level of .08 or better in 2 hours. In short, college students continue to drink alcohol and, for some of them, to intoxication.
One reason collegiate drinking remains so persistent in collegiate culture is that the entire college or university student population turns over every four to six years. New, inexperienced students replace those whose drinking practices changed during their collegiate tenure, often by moderating consumption. Some of these new students arrive on campus with established patterns of alcohol use. Others arrived having abstained in high school or were infrequent users but were introduced to alcohol, given its prevalence on campus. Be that as it may, alcohol was historically and remains a staple of collegiate life.
What has changed in the 70+ years since Straus & Bacon’s report is the availability of evidence-informed best practices that target student drinking behavior. Environmental management (4), the social-ecological model (5), and social norming represent examples of “macro” efforts to affect student drinking behavior, while Brief Alcohol Screening and Intervention for College Students (BASICS) and computer-based brief motivational enhancement activities characterize steps to impact individual decisions regarding alcohol and its use. Reviewing such efforts is beyond the scope of this essay, however. Instead, the argument presented here suggests that preventing high-risk and dangerous student drinking is more cost-effective and philosophically consistent with the mission statements of contemporary institutions of higher education (IHE) than habitually addressing its untoward consequences.
By way of framing this argument, let’s consider tobacco use and its myriad consequences. Seventy years ago, cigarette smoking was not only socially acceptable, it was a perceived social norm in America. Cigarettes were advertised on TV, sometimes by physicians, and socially conscious hosts always provided for the needs of smokers, be it simply by providing ashtrays on conference tables or in the armrests of airplane seats, if not canisters with cigarettes or small “4 cigarette packs” for guests at social events; smoking was expected. The only occasional objection raised regarding tobacco use was reserved for those smoking pipes or cigars. As ubiquitous as smoking was in the AMC series Mad Men,smoking was more prevalent in the reality of mid-20th Century America. Then, things started to change as the first widespread public reports of the links between smoking and heart disease, cancer, and emphysema began to surface.
Initially, the reported links between smoking and health issues were deemed suspicious and met with skepticism. “Big tobacco” questioned the authenticity of government findings, often funding their own “studies” refuting these claims. By the early 1980s, there was not much change in smoking behavior. However, the reports persisted. Then, the focus shifted from exclusively reporting health-related concerns to advocating for the rights of non-smokers with resulting public policy decisions that first mandated areas for non-smokers in public places, then “smoke-free” environments, and then banning the use of tobacco products altogether.
Gradually but consistently, the public became less tolerant of smoking, and attitudes shifted to where tobacco use was relegated to specific areas, frequently to locations protecting the public from “second-hand” smoke, if not banning tobacco use altogether, even in open spaces like public parks and college campuses.
It may have taken 70 years for America’s views regarding tobacco and its use to change, but they did. More to the point, as these attitudes changed, the untoward consequences, especially related to health, started to change…incidents of smoking-related illness began to drop. With a reduction in tobacco-related health problems, fewer associated deaths resulted, and healthcare costs tied to tobacco-related illness and disease declined.
The point of this analogy is to suggest that the costs associated with preventing tobacco use—and note that except for establishing a minimum legal purchase age for tobacco products, the use of tobacco products was not prohibited—were less than the costs associated with treating its health-related consequences. Health education, environmental management, and the use of the social-ecological model resulted in significant changes in behavior. Add to this that as attitudes regarding tobacco use changed, fewer people began to smoke, and more significant numbers of smokers decided to quit. As a result, non-illness-related consequences of smoking started to decrease as well…deaths due to fires associated with smoking in bed, automobile accidents related to drivers distracted when searching for cigarettes and trying to light them, or forest fires resulting from discarded cigarettes are but examples of such reductions.
Now, let’s return to the consideration of preventing high-risk and dangerous collegiate drinking. For the sake of discussion, consider a private college with 4,000 students. Let’s assume that tuition at this college is $35,000 per year, plus room and board, books, and associated fees. It is not uncommon for IHEs to experience a rate of attrition between 10% and 15% a year, with 20% not an unheard-of statistic. Using a conservative rate of 10% attrition, 400 students leave the college each year before graduation. There are numerous reasons students choose to leave. Some decide to transfer to another school with a curriculum better suited to the student’s academic interests. Others flee various quality-of-life issues, such as peer weekend vandalism and violence associated with intoxication. Still, others leave to live closer to home, or, you guessed it, because of overtly alcohol-related issues like academic and/or judicial problems related to their drinking.
Now, let’s do the math: $35,000/student tuition X 400 students leaving = $14,000,000 in lost tuition revenue per year…and this is using a conservative 10% attrition rate. True, not all these 400 left because of alcohol-related reasons, and the college may recruit 400 new students to replace these 400, but keeping an already matriculated student is much cheaper than finding, recruiting, and admitting replacements. Even if 10% of the 400 left because of the intoxicated behavior of peers and another 10% left because of their drinking, 80 students at $35,000 each equals a loss of 1,200,000 tuition dollars due to alcohol-related effects. Plus, who is to say that some of these “replacements” will not bring the same issues that affect the exit of the students they replaced?
So, we have a college with a $1,200,000 loss of revenue per year. Let’s also assume that this college is considering investing in preventing high-risk and dangerous drinking by adding dedicated staff experienced in employing evidence-informed best practices like those cited above. To accomplish this, the college proposes hiring three prevention specialists (6) at $60,000/year + benefits, budgets an additional $60,000/year to hire graduate interns to assist with the more individually if not clinically oriented prevention strategies, things like BASICS, and $10,000 to purchase the necessary licenses to involve all entering students in an evidence-based online brief motivational alcohol education experience (7). This is a total of $250,000 plus benefits for the 3 FTEs…at 25% per employee for benefits, this is another $62,500. Add $7,500 for miscellaneous related expenses…and to make the numbers even… our college is considering an expenditure of $320,000/year to provide prevention services.
At $35,000 tuition per year, how many of the 400 students leaving each year would have to remain matriculated to cover the expense of the prevention program? Again, let’s do the math: $320,000 ÷ $35,000 = 9.143 students. The likelihood that this college’s investment in prevention will result in a minimum of 9.14 fewer students leaving the institution each year is all but a certainty, with the likelihood that any more than 9.14 students who remain each year result in a net return on investment (ROI). In short, if a simple cost-benefit analysis suggests that an investment of $320,000 will likely yield a $320,000+ return, logic suggests it is the prudent course for this college. Add to the tuition that remains at the college the 1) marketing potential in advertising proactive efforts to prevent one of the more “notorious” collegiate problems, 2) likely improvement in campus–community relations, 3) opportunity to demonstrate further efforts to implement the college’s mission statement, and 4) potential impact on the entire campus culture by implementing the social-ecological model and you have a win – win – win – win – win scenario.
Preventing high-risk and dangerous collegiate drinking is not only the right thing to do from a humanitarian perspective, but it demonstrates good business acumen and exemplifies the type of stewardship embodied in the mission statements of every college and university.
[1] Straus, R. & Bacon, S. (1953). Drinking in college. Greenwood Press.
[2] These “subjective measures” are not described
[3] National Institute on Alcohol Abuse & Alcoholism (2015). College drinking. http://bit.ly/1wjXF1k
[6] 1 prevention specialist with a Public Heal/Health Education background employing the social-ecological model, including public policy issues, and 2 clinically oriented prevention specialists experienced in brief motivational enhancement strategies like BASICS.
[7] Something like the College Drinker’s Check-up – see https://www.perplexity.ai/search/what-is-the-social-ecological-bSazfU0.SLGG66T8z9uMbA#1
