Social norms interventions to reduce alcohol misuse in university and college students

Misuse of alcohol can result in disabilities and death. Alcohol also leads to accidents, fights and unprotected sex. Young people aged 15 to 24 years contribute a high proportion to this burden. University students may not drink as frequently as their non-university peers but they have a tendency to drink excessively when they do. Social norms refer to our perceptions and beliefs about what is 'normal' behaviour. People may believe that their peers drink heavily, which influences their drinking, yet much of peer influence is the result of incorrect perceptions. Normative feedback relies on the presentation of information on these misperceptions, about personal drinking profiles, risk factors, and normative comparisons. Feedback can be given alone or in addition to individual or group counselling.
This systematic review was based on 22 controlled trials involving 7275 college or university students randomly assigned to the social norms intervention or a control group. Interventions delivered using the web or computer, or in individual face-to-face sessions, appeared to reduce alcohol misuse. The evidence was less convincing for group face-to-face sessions. Mailed and group feedback were on the whole no different than with the control intervention. Two large studies showed contradictory results for a social marketing campaign. Only a small number of good quality studies were available for many of the outcomes and analyses, and most of the studies were from the USA. The intensity of the intervention differed between trials as did the control intervention, which was no intervention, educational leaflets or an alcohol educational session. Individual face-to-face feedback typically involved social norms feedback as just one aspect of a broader motivational interviewing intervention. Locations where alcohol outlet density is higher may promote higher consumption through more frequent alcohol promotions and easier access to alcohol, so the effectiveness of an intervention designed to reduce drinking could be expected to be lower in these areas.