- The large quantities of alcohol consumed create a serious risk of acute health-harms, including accidents.
- Over time, cumulative alcohol consumption is associated with a wide range of serious health problems.
- The evidence suggests that excessive drunkenness in the night-time economy is linked to patterns of violence and sexual assault
- The behaviour of very drunk people in the night-time economy may also have a direct impact on others who are not drunk, including people working in the night-time economy and local residents.
- The indirect impacts on local communities – such as the costs to police and A&E services in dealing with the fall-out – have also been highlighted.
Participation in drunken nights out is predominantly focused among young adults. But by no means all young adults participate in drunken nights out. The problem of drunken nights out should not be seen as a problem of ‘young adults drinking’.
While drunken nights out are not the only site of alcohol-related harm in our society, they do represent an important piece in the overall picture, and therefore an important problem for Drinkaware to tackle.
What were the knowledge gaps we needed to fill in order to address the problem?
A strategic review was commissioned by Drinkaware and undertaken by Simon Christmas Ltd to address the question of: what role could and should Drinkaware play in reducing the harms associated with drunken nights out?
There were two parts to this question:
- The first part was to understand what is really going on in the drunken night out, and how this generates harm. Why do people drink so much?
- And why, when drunk, to they behave in ways that put themselves and others at risk?
(1) From the outset, the review team had a hunch about the kinds of answer these ‘why’ questions would require. They knew enough about behaviour in general, and intoxication in particular, to realise that answers which focused entirely on the perceived benefits and disbenefits of behaviour – as if a drunken night out consisted of a serious of rational decisions about whether or not to have that next drink – would not capture what was really going on.
To understand why people got so drunk and put themselves and others at risk of harm, Drinkaware would need to understand the role of social norms and contextual influences – and the ways in which both individuals and contexts change through late adolescence and early childhood.
(2) The second part of the question was to identify realistic opportunities for Drinkaware activity to have a positive impact on harm by getting people to drink less, behave differently when drunk, or a combination of the two.
Again, the team had a hunch about the kind of answer needed. There is plenty of evidence that education and communications – the areas of Drinkaware’s expertise – are best deployed as part of a wider package of behaviour change interventions. From the outset, therefore, it was clear that a successful strategy would involve Drinkaware working partnership with others.
How did we go about addressing them?
In order to find out more about what is really going on in the drunken night out, Drinkaware commissioned original qualitative research with participants in drunken nights out aged 18-29. This was conducted alongside a review of literature and data sources – including a re-examination of Drinkaware’s own data – and interviews with key informants.
The first phase of qualitative research saw 48 young adults take part in an intensive process involving supported pre-work followed by 90 minute face-to-face interviews. In a second phase of research, a series of ten workshops (each with six participants) was held, some with participants from the first phase and some with newly recruited participants. In total, 80 participants were involved across both phases of the research.
What did we find out?
Full details of the research findings can be found in the report on the strategic review, Drunken nights out: motivations, norms and rituals in the night-time economy. Some key points were as follows:
- Drunken nights out are not undertaken by individuals, but by small groups of friends. Behaviour on a drunken night out has to be understood in the context of this group.
- However chaotic they may seem, drunken nights out are in fact structured by norms and rituals – albeit very different ones from the norms and rituals of everyday life.
- People participate in drunken nights out precisely because they provide an escape from the norms of everyday life, and an arena in which more intense and extreme social interactions are permitted – both within the group of friends, allowing group bonding, and with strangers, allowing ‘social adventures’. All of these become material for stories to be told after the event.
- A powerful norm of drunkenness has developed in this special social context. Drunkenness is a required condition of taking part in a drunken night out – in contrast to the many other social contexts in which drunkenness is merely an allowable consequence of taking part. To put the point another way: drunkenness has effectively become an entry ticket to the drunken night out – one reason why pre-drinking (see below) is so entrenched.
- Drinking in the context of the drunken night out is largely instrumental. The only reason to drink is in order to get drunk. For many of our participants, indeed, this was their only relationship with alcoholic drinks. For example, many did not like the taste of the drinks they drank, while some saw drinking if one wasn’t getting drunk as a waste of alcohol.
- The practice of pre-drinking may well have started as a way of saving money, but now plays many roles: meeting the need to be drunk before one goes out, and to synchronise levels of drunkenness in the group; providing a more conducive environment for group bonding; as a ritual passage from everyday life to the special arena of the drunken night out; and, at a practical level, filling the time until everyone else goes out – because they are all pre-drinking too.
- The relaxation of social constraints in the drunken night out allows for social adventures – but also creates risks of unwanted extremes, such as physical violence and sexual assault. The responses of participants suggested that sexual molestation and groping have become common experiences on a drunken night out.
- Participants in drunken nights out are conscious of these social risks – in stark contrast with the risks of acute harm (which were acknowledged when prompted but not otherwise considered) and risks of long-term health harm (which were discounted entirely, even when prompted).
- Participants also described strategies to minimise these social risks, such as knowing one’s limits and looking after each other in the group. However, there is good reason to believe that these strategies all too often fail.
How did we develop the strategy?
Development of an evidence-based strategy for Drinkaware was an iterative process. This began with a stakeholder event, held after the first (interview) phase of the qualitative work, at which interim findings were discussed and potential areas for intervention explored. Materials based on these discussions – e.g. possible campaign propositions – were explored further in the second (workshop) phase of the qualitative work, providing a deeper understanding of both the opportunities and challenges for intervention.
The strategic review process concluded with the identification of four possible strategic territories for Drinkaware – for example: strengthening the intentions of group members to look out for each other; eroding the assumption that, if you’ve ‘got away with it’ on the night out, you’ve ‘got away with it’ altogether; or making participants in drunken nights out feel more personally vulnerable to negative outcomes, and less personally safe.
The strategy adopted by Drinkaware focuses on the dynamic at the very heart of the drunken night out: the special social arena in which more extreme and intense social interactions are permitted. It builds on the insight that, while participants in drunken nights out value the ‘social adventures’ possible in this special arena, that doesn’t mean they have no boundaries.
Unfortunately, there is a lack of agreement among drunken night out participants about where those boundaries lie, and very different ideas regarding the acceptability of aggression, violence and sexual behaviour.
In particular, sexual harassment, groping and molestation are a common occurrence: something that many young adults have come to expect, even though they find it unpleasant or distressing. There are worrying indications regarding the connections between this ‘normalisation’ of low level harassment and more serious sexual assault.
In an additional survey conducted for Drinkaware Nearly a third of young women (31%) and 1 in 10 young men (11%) aged 18-24 said they received inappropriate or unwanted physical attention or touching on a drunken night out. Most of the young people (66%) spoken to in the survey said that persistent unwanted sexual attention ruins a good night out. Young women who experienced this told us that it left them feeling disgusted (69%), they also reported feeling anger (56%) and fear (38%).
It’s worth stressing that both sexes dislike the normalisation of harassment in the drunken night out. Young women are often on the receiving end – but harassment sometimes comes from other women. Young men are less likely to be directly targetted, but may find themselves caught up in violence as a result of rebuffed advances.
In particular, young men may attack the male friends of a woman who rebuff them, or more generally start ‘looking for a fight’ when rebuffed. Drinkaware’s strategy is to challenge this harmful behaviour, and promote the development of new boundaries, by reminding young people that they wouldn’t perpetrate or accept sexual molestation outside the context of a drunken night out.
At the heart of the strategy is a simple proposition: There are still limits, even when you’re drunk. If behaviour is inappropriate when you’re sober, it’s inappropriate when you’re drunk.
The strategy seeks to create a negative image of those who perpetrate sexual harassment and a positive image of those who are willing to speak out against it. The hypothesis is that doing so will result in people behaving differently, even when drunk – so being less likely to be a perpetrator of and more likely to speak out against this kind of antisocial drunken behaviour.
How was the strategy translated into a social marketing campaign?
There were three key strands to the development of this strategy into a pilot campaign:
- Building a partnership
- Developing an awareness-raising campaign
- Piloting an on-the-ground behaviour change intervention
Drinkaware had recognised from the outset the need to work as part of a partnership to develop a project that would affect real change. Building that partnership was, therefore, the first strand of activity. As part of the Home Office’s programme of Local Alcohol Action Areas, Drinkaware teamed up with the Nottingham Crime & Drugs Partnership to deliver a comprehensive local pilot in Nottingham and Nottinghamshire.
Drinkaware’s work in Nottinghamshire took place against a backdrop of ‘business as usual’ activity seeking to reduce alcohol related harm. This included the Nottinghamshire alcohol policy landscape as shaped by PCC and Police priorities, Health & Well-being Board, CCG, and national initiatives. In particular, there had already been a considerable focus on the night-time economy in Nottingham city centre, with schemes in places such as Pubwatch and Best Bar None, a late-night levy (outside BID), reductions in the number of vertical drinking venues, a campaign to reduce availability of super-strength products, and Street Pastors. Having applied for joint status as a LAAA, Nottingham city and Nottinghamshire county implemented further initiatives such as the Cardiff model of A&E reporting and ID scanners and breathalysers at the doors of clubs. These further initiatives included a communications strategy which sought to address various areas of alcohol related harm through marketing and communications. Our own campaign sat within this overarching communications strategy.
The second strand of the pilot involved the development of an awareness-raising advertising campaign. A series of creative executions of the core proposition were developed by creative agency Leith, and tested in a series of workshops with the target audience by 2CV. These workshops confirmed that different social norms apply on nights out. As a 21 year old male respondent explained: “The rules are just different on a night out drinking. There are different boundaries and everyone knows that”. They also confirmed that sexual harassment and molestation have become, in this context, normalised behaviours, and found a difference in how this played out with for male and female respondents:
- Male respondents acknowledged the issue, but tried and make excuses for it. As one 23 year old said: “If I foul someone playing football, it’s a foul but in the context of a game it happens. If I did it in the street, it’s a crime. Some of this stuff’s the same. Touching girls is wrong but in the context of a bar or club when everyone’s pissed, it’s kind of part of the game. In the cold light of the day you wouldn’t because the rules are different”.
- Female respondents, on the other hand, saw the behaviour as unacceptable and a problem, albeit one that comes with the territory. As one 21 year old woman said: “Guys are just all over you, gyrating behind you, grabbing your boobs, taking photos up your skirt. They just wouldn’t do it if they wasn’t drunk”.
The central message of the campaign: If you wouldn’t sober, you shouldn’t drunk resonated strongly with both genders. The campaign launched in October 2014 and ran across local cinemas, digital and social media, and in local venues for two months.
The third strand, lead by BrainJuicer, involved the development of an on-the-ground behaviour change intervention, with “club hosts” (themselves young adults) trained to protect vulnerable people, create a positive social norm, identify and deal with problems before they escalated, and help victims of sexual harassment. Club hosts worked in three venues in Nottingham and Mansfield on Friday and Saturday nights over 7 weeks.
What were the results?
Both the advertising campaign and club hosts intervention have been evaluated against the objectives set for this pilot phase of activity. In particular, the pilots were designed to establish whether investment in larger-scale campaigns was warranted, and how those larger campaigns should be taken forward.
In the case of the club hosts, it is encouraging that customers appreciated the presence of hosts, that their overall impact in the bars they worked in was perceived as positive, that bar managers found the intervention worthwhile and were happy to have the hosts onsite, and that the hosts logged nearly 50 incidents of vulnerable people needing their help during the short time they were working – over and above the many conversations they had with people.
But the main purpose of this initial first phase has been to learn about and improve a novel intervention, prior to a further stage of work which will see the evaluation of the (refined) intervention over a longer period of time.
With this in mind the evaluation of this initial development pilot, carried out by BrainJuicer, focused on gathering qualitative learning about how best to deliver the club host intervention. For example, the research highlighted the potential value of broadening the scope of host activity to cover wider issues around personal boundaries and vulnerability.
The pilot experience has underpinned the development of an implementation protocol and business case, critical if more clubs and bars are to be recruited to take part in further trials.
Evaluation of the advertising campaign was undertaken by BrainJuicer, and used an industry-standard approach involving pre- and post-wave surveys among the target audience (young adults who participate in drunken nights out). Recruitment was undertaken via a variety of routes, including bar/club Facebook pages, paid for advertising on Facebook, and a local student site. 212 participants responded to the pre-campaign wave, and 155 to the post-campaign wave.
The survey results indicate that:
- The campaign was being seen by the target audience, with the percentage who had seen a campaign on sexual harassment rising from 35% pre- to 53% post-campaign, and 70% prompted recall of campaign elements.
- The campaign resonated with survey respondents, many of whom felt it was important to raise awareness of this issue. Females were especially positive.
- The campaign was prompting people to talk about the issues, with the percentage of respondents who had ‘discussed with friends the issue of sexual harassment in clubs and bars in the last month’ rising from 28% pre- to 40% post-campaign.
- The campaign was also prompting people to reconsider their views on the behaviours in question. For example, the percentage agreeing (totally agree or tend to agree) that ‘It’s never ok to grab or touch someone else in a bar unless it’s clearly consensual: alcohol is no excuse’ increased from 59% to 67% overall (and from 55% to 67% among males). The percentage totally agreeing with this view rose from 28% to 38% (and from 20% to 29% among males).
- The percentage who claimed to have intervened when they observed different forms of harassment also rose, from 17% to 27% for grabbing or groping, 16% to 29% for sexual remarks, and 7% to 13% for ‘grinding’ on the dance floor. While it seems unlikely that these claims reflected actual behaviour during the campaign, they may indicate something about how respondents wanted to be seen – something of great relevance to both their future behaviour and, potentially, the development of new norms.
Overall, the pilots have demonstrated both the strategy’s potential and the value of further large-scale trials. Drinkaware have committed to expanding the advertising campaign to a larger region and collecting data over a longer period in order to measure the impact over time.
In parallel, the club hosts initiative will be taken into a multisite trial to study its effectiveness and impact.