After 43 years of distinguished research and teaching at HSPH related to high-risk behavior-especially alcohol consumption among college students-Henry Wechsler formally retired from the School on January 1, although he plans to continue to "work and write about the issue of high-risk behaviors and other public health issues," he said.
From left to right, Toben Nelson of HSPH, Donald Ziegler of the American Medical Association, Henry Wechsler, and Elissa Weitzman of Harvard Medical School and Children's Hospital at a celebration honoring Wechsler
In 1992, the Robert Wood Johnson Foundation offered funding for Wechsler to lead the College Alcohol Study (CAS), a comprehensive look at campus alcohol and tobacco use. The original CAS and three subsequent national surveys of thousands of college students across the nation have added greatly to the body of knowledge in the field of substance abuse. They are among the most widely cited studies in the field.
Over the years, Wechsler and his team-including HSPH research associate Toben Nelson-learned that in 1993 more than two out of every five college students were binge drinkers, a rate that continues today. Wechsler defines binge drinking as having five or more drinks in a row for men and four or more drinks in a row for women at least once in the past two weeks.
Former student Isidore Obot, '84, who was a senior researcher on mental health and substance abuse for the World Health Organization, noted: "At every turn in my travels and in meetings with professionals, researchers, and policymakers, I hear people use the concept of 'binge drinking' which Henry popularized, sometimes not exactly in ways he would approve." Obot now chairs the Department of Behavioral Health Sciences of the School of Public Health & Policy at Morgan State University in Maryland.
"This is seminal work," said Nelson. "Henry took the study of this issue out of the realm of the single campus and the individual. The CAS cuts across campuses and looks at a broad range of drinking behaviors. The study has put [the issue of college binge drinking] out on the table for people to think about and to confront."
Steve Schroeder, former president of the Robert Wood Johnson Foundation and current professor of medicine at University of California-San Francisco Medical School, credits Wechsler with opening the eyes of the public to the concept of second-hand damage from drinking, which he believes is akin to passive smoking. Wechsler was principal investigator of a study that evaluates the Robert Wood Johnson Foundation Matter of Degree Program, which operates several model interventions to curb campus drinking.
The social costs of campus binge drinking are tremendous, agreed Nelson, affecting not only individual students who damage their own academic careers, but also the school itself in terms of vandalism, dropouts, the social cost to other students, and safety and health costs to the surrounding communities. Drunk driving, assaults, health problems, attempted suicide, unsafe sex-the fallout from a night of heavy drinking on or off campus can be costly and dangerous to many in the surrounding area.
Although heavy drinking is not new to college campuses, the CAS has helped reframe the issues. Wechsler's data make it clear that cultural and commercial factors on and around campus actually promote irresponsible drinking, as much or more than the behavior of individual young adults. When alcohol is inexpensive, readily available, and heavily promoted in the media, many students-including those under the legal drinking age-drink, and, often, to excess.
"Just because beer, in contrast to drugs, is familiar doesn't make it safe in the hands of young people," Wechsler said.
For those who assume that alcohol problems exist only at so-called "party schools," Wechsler suggests that college administrators, "Go around with your campus police, and you'll see what's going on."
Wechsler offers this advice to campuses and college towns that want to alter their alcohol environment: Don't let your bars serve supersized drinks in fishbowls to students. End special pricing at stores that make it cheaper to buy large quantities of beer. Encourage bars to ban "ladies free" nights and other special inducements to heavy drinking. Work to reduce the number of liquor licenses allowed in your community.
The CAS "stimulated a number of schools to initiate efforts to reduce binge drinking behavior, many of which are still ongoing today," said Lloyd Johnston of the University of Michigan and principal investigator of the Monitoring the Future study, which tracks trends in substance use by American high school students and young adults. "The CAS also served the important function of documenting the many adverse consequences that flow from widespread drinking to excess-information that has helped to educate college and university students as well as officials and, one hopes, to deter many students from going to such extremes in their own use of alcohol."
Wechsler told those attending a celebration in his honor in November at the Harvard Club of Boston that he appreciated the opportunity to make a contribution to the field and to see some of his findings widely disseminated.
"It's encouraging that colleges now pay greater attention to the problems I have highlighted, even though their actions may as yet be inadequate," he said.
—PHC
Findings from the College
Alcohol Study
- Two in five students, or 44 percent, who attend four-year colleges binge drink.
- Binge drinkers consume most of the total alcohol imbibed by college students.
- Frequent binge drinkers-who comprise one in five college students-consume a median of 14.5 drinks per week.
- One-quarter of college students who drink do so 10 or more times a month. Three in 10 report being intoxicated three or more times in a month.
- Almost half of college students who drink do so for the primary purpose of getting drunk.
- Little has changed in the pattern of student drinking during the years of the four CAS surveys, with the one notable, polarizing exception. There have been simultaneous increases in the number of abstainers and in the number of students who engage in frequent binge drinking.
Copyright, 2009, President and Fellows of Harvard College
