Health Education Research, Vol. 19, No. 1, 64-70,
February 1, 2004
© 2004 Oxford University Press
The misperceived social norm of drunkenness among early adolescents in Finland
1 Tampere School of Public Health, 33014 University of Tampere, Finland 2 Correspondence to: T.P. Lintonen; e-mail: tomi.lintonen@uta.fi
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Abstract |
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Adolescents tend to overestimate peer drinking; the resulting misperception of the social norm predicts the child’s own future drinking. This study examined the misperception’s relatedness to a person’s drinking pattern in order to facilitate the segmentation of the audience for health education interventions. Adolescent Health and Lifestyle Survey (Finland) data on 14 year olds’ drinking patterns and perceptions of peer drinking were gathered using self-administered mailed questionnaires in 1989 (N = 3105, response rate 77%), 1995 (N = 8382, 79%) and 2001 (N = 7292, 70%). The perceptions of peer drinking were significantly related to respondents’ drinking patterns. Non-drinkers and those drinking recurrently until drunkenness held reasonably correct views of their peers’ drinking. However, the segment between these two extremes comprising around half of the cohort incorrectly thought that their peers drank more; they misperceived the normative drinking pattern to be drunkenness. From health education perspective, three different target audiences can be identified: non-drinkers, moderate drinkers and heavy drinkers. The intermediate group, drinkers not normally getting drunk, holds the view most influenced by the social norm misperception and are likely to feel pressured to increase their drinking. The social norms marketing approach to health education should find this group the most viable target.
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Introduction |
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Alcohol drinking and especially drunkenness-oriented drinking among Finnish early adolescents has appeared widespread in comparison with most European countries [e.g. (Currie et al., 2000
)]. Furthermore, drinking has increased and the drinking patterns have become more drunkenness-oriented in the past 20 years (Lintonen, 2001). A recent national health policy statement in Finland (Valtioneuvoston Periaatepäätös, 2001) has set clear goals for reductions in drunkenness-oriented drinking. The challenging situation calls for both new initiatives in the alcohol policy and revision of health education methods.
According to Social Learning Theory (Bandura, 1972) and Social Cognitive Theory (Bandura, 1986), adolescents are active in seeking information on which to base their behavior. Hollander defined social norms as ‘standards of behavior expected of members of a given social group of an entire society’ [(Hollander, 1976), p. 6]. Adolescents form their relationship with alcohol based on societal traditions, observations of others’ behavior and also on beliefs on how their peers drink. Most western countries have legislation aiming at postponing the adoption of alcohol drinking until late teen years. Nevertheless, drinking experimentation usually begins in early adolescence [e.g. (Ahlström et al., 1994; Currie et al., 2000)]. Several studies have concluded that adolescents tend to overestimate peer smoking and drinking [e.g. (Haines and Spear, 1996; Perkins et al., 1999)], and this is true also in Finland (Bruun and Hauge, 1963; Ahlström et al. 1994). The resulting social norm misperception may be interpreted as resulting from pluralistic ignorance—the belief that one’s private attitudes are different (in this case, more conservative) from those of others’, even though one’s public behavior is identical (Miller and McFarland, 1987). Mäkelä (Mäkelä, 1997) proposes that in countries with restrictive alcohol policies the perception that others drink more may be a way of reducing the cognitive dissonance (Festinger, 1957) between the ideal of abstinence in adolescence and the reality.
Perceiving heavy drinking as ‘typical’ may act as a pressure towards adopting such behavioral patterns. Mäkelä (Mäkelä, 1997) is rather critical about the idea that the misperception actually acts as a pressure to increase drinking. Empirical studies, however, support the view that the perceptions rather than actual peer use of alcohol influences adolescent drinking (Iannotti and Bush, 1992). Furthermore, in longitudinal studies, the misperception has been shown to predict the child’s own future substance use (Downs, 1987; Graham et al., 1991; Botvin et al., 1992; Marks et al., 1992). It has been proposed that health education programs designed to correct this misperception have a good chance of reducing the adoption of more severe drinking patterns (Graham et al., 1991).
Individuals can react to the perception that others drink more in at least three ways (Prentice and Miller, 1993): (1) move their attitudes towards the perceived norm, (2) bring the norm closer to their attitudes or (3) reject the reference group altogether. The authors suggest that the latter two options are usually too costly for the individual; thus the perceived norm is commonly accepted and followed.
Measures to reduce under-age drinking in Finland have been developed and implemented throughout the 1990s apparently with little success (Lintonen, 2001). Alcohol policy, or rather its implementation, has failed to curb under-age persons’ access to beverages containing alcohol (Ahlström et al., 1994). Health education interventions aiming at reducing under-age drinking have, at large, been evaluated as being rather ineffective (Edwards et al., 1994; Bergmark and Andersson, 1999). However, there have been promising results related to interventions aimed at reducing drinking through addressing the misperceptions of peer drinking (Haines and Spear, 1996; Schroeder and Prentice, 1998; Komro et al., 2001). A study at a North American college (Haines and Spear, 1996) displayed reductions both in the perceptions and prevalence of binge drinking after a 4-year campaign to distribute factual information on the drinking practices in the campus. Among younger adolescents, Project Northland (Komro et al., 2001) showed significant reductions in drinking as a result of a community trial using multiple path methodology; estimates of use by peers were one of the key mediating factors responsible for the change.
The aim of this article was to study the extent and time trends of misperceptions on peer drinking among Finnish 14 year olds from the year 1989 to 2001. Since, at this early age, the adolescents are in very different stages of getting acquainted with alcohol and thus experience different social contexts, it was hypothesized that the misperceptions were not uniform among adolescents, but related to their own level of involvement with alcohol. If this is the case, health education aiming at correcting misperceptions on peer drinking should adjust its message accordingly to different target audiences.
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Method |
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The data were secured from the Adolescent Health and Lifestyle Survey in Finland (Lintonen, 2001
). Self-administered 12-page questionnaires were mailed to nationally representative samples of 12, 14, 16 and 18 year olds every other year; this present study concentrates on the drinking data on 14 year olds from 1989, 1995 and 2001. In order to increase the response rate, two re-inquiries were sent to non-respondents. The samples were obtained from the Population Register Center and were based on particular dates of birth, so that all Finns born on sample days were included. The numbers of respondents were 3105 in 1989, 8382 in 1995 and 7292 in 2001; the response rates were 77, 79 and 70%, respectively.
Respondent’s current drinking pattern was combined from two questions on drinking and drunkenness frequencies. Drinking frequency was investigated with the question: ‘How often do you use alcohol? Try to include even those occasions when you only consumed small amounts of alcohol’. The alternatives were: ‘daily’, ‘a few times a week’, ‘once a week’, ‘a few times a month’, ‘about once a month’, ‘about once in 2 months’, ‘3–4 times a year’, ‘once a year or less frequently’, ‘I do not use alcohol’. Drunkenness frequency was measured using the question: ‘How often do you use alcohol until you are really drunk?’, The alternatives were: ‘once a week or more often’, ‘once or twice a month’, ‘less frequently’, ‘never’. The resulting outcome variable had five categories: drunk weekly, drunk monthly, drunk at times, drinks but not until drunkenness, non-drinker. The perception of peer drinking was derived from a three-category question: ‘If you compare yourself with other same age and same sex adolescents, do you think that most of them drink:’ ‘more than you’, ‘as much’, ‘less than you’. The results are displayed as percentages and the independence of the variables was tested using 
2 statistics. Time trends in perceptions were tested using logistic regression with ‘more than you’ versus ‘as much or less than you’ as the dependent variable; significance level was set at P < 0.05.
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Results |
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Most 14 year olds either did not drink alcohol at all or at least did not drink until drunkenness (Table I). Boys’ alcohol drinking pattern was not associated with the study year (P = 0.236), while girls’ pattern was (P < 0.001). The proportion of those reporting drinking until drunkenness at least once a month remained the same among boys from 1989 to 2001, but increased among girls.
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Same age/sex peers were perceived to drink more than oneself; 80% of boys and 82% of girls shared this view. The view on peer drinking was significantly associated with respondents’ drinking patterns (P < 0.001, Table II). Between 84 and 89% of non-drinker boys and 93 and 97% non-drinker girls perceived their peers as drinking more than themselves. At the other end of the drinking pattern spectrum those drinking until drunkenness weekly mostly held the view that their peers drank the same way or less. The yearly variations among those drunk weekly were partly due to the fact that the numbers of respondents were small in this drinking pattern category (15 boys and 24 girls in 2001). The perceptions changed towards a greater proportion of 14 year olds perceiving others as drinking more than themselves.
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Figure 1 divides the perceived drinking of others into two components: the percentage of those actually drinking more and the percentage misperceived as drinking more. This division is shown for each drinking pattern category from non-drinking to weekly drunkenness. For example, the extent of misperception among those boys who reported to have been ‘drunk at times’ was calculated by subtracting weekly and monthly drunkenness prevalence rates (Table I: 1 + 6% = 7%; shown in Figure 1 as the shaded part of the bar) from the proportion of respondents perceiving others as drinking more within the category ‘drunk at times’ (Table II: 68%; the combined length of the bar). The misperception (68 – 7% = 61%) is displayed as the black part of the bar in Figure 1. The respondents’ misperceptions were greatest in categories ‘drinks but not until drunkenness’ and ‘drunk at times’. Non-drinkers and those drunk monthly were closer to observed prevalences in their perceptions, while those drunk weekly were quite accurate in their evaluations of peer drinking patterns. The results were similar for all the study years; no statistically significant time trends were identified.
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Discussion |
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Finnish 14 year olds have held considerable misperceptions of peer drinking patterns during the period from 1989 to 2001: overall more than four out of five 14 year olds thought that their age mates drank more. The situation did not change over time. The perceptions of peer drinking were related to respondents’ own drinking patterns; among both girls and boys the extent of misperception was most substantial among those drinking moderately. This group comprised around half of the 14 year olds.
The results are based on a nationally representative, large data set with a reasonably good response rate. In a methodological study on the same data (Lintonen et al., 2000) it was concluded that the non-respondents were likely to be heavier drinkers than the respondents—thus the drinking prevalence rates are slightly underestimated. Evidence for both over- and under-reporting of alcohol use has been presented together with views that, in a research situation, early adolescents tend to report their use rather accurately (Lintonen, 2001). To our knowledge, no methodological studies on how adolescents may purposefully misreport their peers’ drinking have been published. Although not yet supported by empirical evidence, Mäkelä (Mäkelä, 1997) may be correct in his suggestion that adolescents over-report peer drinking behavior partly to reduce their cognitive dissonance. Regarding this present study, the implication would be that those drinking heaviest would also distort their reports on peer drinking the most. Care should be taken when interpreting the results; especially the limitations resulting from the data collection are to be noted. However, the conclusions are not likely to be altered by the inaccuracies imposed by the methods.
Social influences promote the spread of drinking in adolescence; this study addressed the issue of social norms misperception. In contrast to Finnish adults, whose estimates were anchored in reality (Mäkelä, 1997), adolescents perceived drinking and drunkenness to be the norm at their age, while in reality the majority of this age group did not drink, at least not until drunkenness. The misperceived social norm challenges the early adolescents to alter their drinking behavior towards heavier drinking, although they may have considerable misgivings of the desirability of such behavior. Correcting the estimates for peer drinking practices has been shown to be an effective way of reducing the uptake and development of drinking among young adolescents (Komro et al., 2001).
Analytically, this study offers little to explain where the misperceptions originate from. It is possible that in social situations, attention is directed towards those drinking more and/or appearing to be drunk, while the majority behaving more conservatively gets less attention. Furthermore, the misperception may gain strength from the want to associate with peers who appear ‘more mature’; i.e. those who exhibit more severe substance use patterns. Plumridge et al. (Plumridge et al., 2002) build on the ideas of ‘performativity’ and ‘social space’ in investigating the power relation and status statements imbedded in smoking. It is possible that drinking, especially drunkenness, affords similar opportunities for performing coolness.
In addition to situationally biased information, previous research has pointed out that the perceptions are particularly biased in the frequency compared with the quantity domain (Baer et al., 1991). Thus adolescents’ misperceptions of others’ heavier drinking practices may result both from the exaggerations of drunkenness as the pattern and the recurring nature of drinking.
Highly visible societal concern over under-aged drinking (Torkkola, 1998) may also be a viable explanation for the development of the misperception. The tendency of the media to focus on the negative and exaggerate this can significantly contribute to the biased view. Also, due to much media and adult concern over the matter, adolescents may use heavy drinking purposefully to express rebellion.
Like media coverage, health promotion messages may act against their intended purpose if they single-mindedly distribute the message that ‘there is so much drinking going on’. Olds and Thombs (Olds and Thombs, 2001) suggested that health educators should refrain from emphasizing the commonness of drinking and exerting pressure on the adolescents about the ‘choice’ they have to make. Rather, factual, preferably local survey data, should be used in marketing a more realistic social norm regarding drinking.
Regardless of the origins of the norms’ misperceptions, the biased beliefs are likely causes of increased drinking both on individual and group levels. The situation is even worse from the health promotion point of view since the situation leads the adolescents to believe that although ‘everyone’ drinks rather heavily, only a few experience serious harm.
While a widespread misperception of the normative nature of drinking and drunkenness prevails, health education is faced with a situation calling for innovative approaches to preventive work in alcohol use. One possible approach would be to move the focus of such work towards alternative activities. Also, publicity could be used to highlight the non-normative nature of heavy drinking. Regarding substance-specific health education, three different target audiences can be identified. Non-drinkers have chosen to abstain, at least for the time being, from drinking alcohol despite their knowledge that many others drink alcohol; their position should be supported. Second, among those drinking continually until drunkenness, the observed peer drinking patterns support maintaining the current pattern. Concerning this segment, the emphasis should clearly be on reducing drinking, perhaps highlighting the actual short-term harm associated with heavy drinking (i.e. violence, accidents). The third group, ‘moderate drinkers’, holds the views most viable to be influenced by the norm misperception. Towards this group comprising roughly half of the cohort, the message could be based on the fact that only a small proportion of their peers actually does drink until drunkenness despite their high visibility both in the media and social situations. Factual data on the commonness of heavy drinking obtained as close as possible to the target audience themselves should be an important tool in getting the misperceptions corrected. Notwithstanding all the publicity, getting drunk is not the norm.
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Acknowledgements |
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We wish to thank the Ministry of Social Affairs and Health (Finland) and Emil Aaltonen Fund for financial support.
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References |
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Received on July 9, 2002; accepted on November 9, 2002
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