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13
Drinking and Coming of Age in a Cross-Cultural Perspective

Robin Room

Over the past two centuries, societies influenced by the 18th-century Enlightenment have constructed an ideal of childhood as a protected and liminal stage of life (Aries, 1962; Kett, 1977). Children became exempted and excluded from participation in the labor market by child labor laws, and the innocence ascribed to them was protected by means such as film classifications and sexual abuse laws. Different age-grades of childhood and adolescence became largely segregated from other age-grades and from the adult world by separate schools at different levels. The child eventually became the woman or man, but the process of becoming a woman or man was conceived of not in terms of a specific rite of passage at a particular time, but in terms of a process with many stages.

COMING OF AGE AS A PROCESS

During the course of this long process, the child/adolescent is defined to some extent as an acolyte to his or her future as an adult. Children are protected to some extent, through arrangements such as juvenile courts and sealed records, from such potential blights on their adult life as a criminal record. But parents, teachers, and other adult guardians define the central task of the child and particularly of the teenager as preparing through education and otherwise to take a full place in adult life, and are concerned about anything that might impede this preparation and about behaviors that may stain future status or injure future functioning in adult life. In this cultural context, there is particular concern about behaviors and experi-



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Reducing Underage Drinking: A Collective Responsibility 13 Drinking and Coming of Age in a Cross-Cultural Perspective Robin Room Over the past two centuries, societies influenced by the 18th-century Enlightenment have constructed an ideal of childhood as a protected and liminal stage of life (Aries, 1962; Kett, 1977). Children became exempted and excluded from participation in the labor market by child labor laws, and the innocence ascribed to them was protected by means such as film classifications and sexual abuse laws. Different age-grades of childhood and adolescence became largely segregated from other age-grades and from the adult world by separate schools at different levels. The child eventually became the woman or man, but the process of becoming a woman or man was conceived of not in terms of a specific rite of passage at a particular time, but in terms of a process with many stages. COMING OF AGE AS A PROCESS During the course of this long process, the child/adolescent is defined to some extent as an acolyte to his or her future as an adult. Children are protected to some extent, through arrangements such as juvenile courts and sealed records, from such potential blights on their adult life as a criminal record. But parents, teachers, and other adult guardians define the central task of the child and particularly of the teenager as preparing through education and otherwise to take a full place in adult life, and are concerned about anything that might impede this preparation and about behaviors that may stain future status or injure future functioning in adult life. In this cultural context, there is particular concern about behaviors and experi-

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Reducing Underage Drinking: A Collective Responsibility ences that are morally suspect, but legally tolerated in adults. In fact, laws on the protection of children are often the signal of a residual cultural disapproval of behaviors that were at some time not only immoral, but illegal for everyone. There is also a generalized concern about joining the adult world “too early.” Holding a full-time job is not morally suspect and does not necessarily injure a child’s future status, but our cultural and legal systems forbid this level of employment below a given age. Where exceptions must be made, as for child actors, the U.S. system imposes elaborate legal restrictions and requirements in an attempt to ensure the actors have a “proper childhood.” The proliferation of legal restrictions on behavior by chronological age is a relatively modern phenomenon. Age minimums for drinking, for example, mostly date back only to the post-Repeal era (Mosher, 1980). Differentiations of status in terms of life stages have a much longer and broader history. But the modern legal restrictions both express and encourage a cultural tendency to think of these status differentiations in a particular way: in terms of chronological age. In a strongly universalistic cultural and legal frame, a fixed chronological age applying to everyone is a legal definition of adulthood that is more comfortable and more easily defended than any criterion based on an individualized assessment of maturity or on a civil status (e.g., marriage) would be. Of course, a more universalistic standard for behaviors seen as inappropriate for children is to forbid them for everyone. Minimum age restrictions cannot exist, of course, for behaviors that also are illegal for adults, such as marijuana use. Emancipation and Settling Down: The “Social Clock” Part of growing up is to try out and to adopt new behaviors. Although the process is often fraught with anxiety for the person growing up, it is often even more anxiety producing for parents and other adults involved. This anxiety or disapproval may arise if the adolescent tries out the behavior at all. But often it is also about the age at which the behavior is adopted. Behavior that is seen as too “grown up” for one age may be accepted without too much fuss if it occurs at a later age. In the context of discussions of social problems and youth, the focus tends to be on behaviors that are taken on “too young.” But in a wider frame, there is also growing unease if a young person does not try out and take on a behavior at what is believed to be an appropriate age. Failing to have a full-time job by the age of 25 may be seen as equally inappropriate as holding a full-time job at age 12. Sociologists talk of these normative standards for when a behavior or status should be taken on as the “social clock” (Neugarten, Moore, and Lowe, 1965). The normative standards for

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Reducing Underage Drinking: A Collective Responsibility the social clock for any given behavior or status are likely to vary in time and by cultural group. We can think of the period of adolescence and young adulthood in terms of two complementary processes: emancipation and settling down. The content of emancipation includes the various behaviors for which there are minimum age requirements, as well as such aspects as staying out late at night and moving out of the parental home. By “settling down” we mean the culturally normative process of taking on an accumulation of continuing obligations: a car loan, a “real” (nontemporary) job, a marriage, a child, a house mortgage, and so on. Along with the general legal provisions we have mentioned, the emancipation process is governed by strong general cultural expectations. By its nature, the process nearly always involves a generational tug-of-war within the family. The general cultural expectations about the settling down process are also quite strong, but legal age minimums and the struggle within the family are usually much less involved in the process. In the individual life history, emancipation and settling down may be linked closely, such as when a daughter does not leave the parents’ home until she marries. Characteristic of modernity is a considerable temporal separation of the two processes, leaving a significant liminal space in adolescence and early adulthood. Contrary to common belief, this transitional status and period also have been common in other societies and times (e.g., Sarmela, 1969). Emancipation and Contested Behaviors As the existence of the minimum-age laws suggests, the process of emancipation involves many behaviors we may describe as “contested” (Gusfield, 1996). Some of these behaviors—driving a car, getting a job, having sex—are expected for nearly everyone to happen eventually as part of adult life, but to engage in them too early is seen as upsetting or even shocking. Other behaviors are legal but grudgingly tolerated for adults, and there is at least hope the process of emancipation will not include them. Thus most parents hope their children will never take up cigarette smoking. Other behaviors are illegal for everyone, but common in the emancipation process: marijuana smoking, for example, as well as behaviors with victims, such as vandalism and violence. The contest is generational, between teenagers and young adults on the one hand and adults in general and school and civic authorities on the other. It is also intensely personal within the family: Parents find themselves on the front line, locked into a role as guardians of conventional hopes and expectations against the claims for autonomy and emancipation of their offspring. For many parents, the process of emancipation feels like a long process of grudging retreat from their preferred standards of conduct. As

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Reducing Underage Drinking: A Collective Responsibility Williams (1960) has discussed, a last fallback expedient in upholding a norm is a “patterned evasion,” that is, ignoring evidence of its violation. The parent scoots past the couch with eyes averted, rather than face up to the reality of the entangled limbs there. There is also considerable patterned evasion of norms at a societal level: Nearly all who will eventually drink alcoholic beverages in the United States start doing so before the legal drinking age. In terms of the general “social clock” concerning ages at which potentially contested behaviors are found acceptable by a majority of adults in North America, mean ages probably range from about 171/2 to 20, judging by data from Ontario (Paglia and Room, 1998). In 1996, adults in Ontario were asked, “Regardless of what the law says, how old do you think a male/ female should be before it’s OK for him/her” to engage in each of a list of behaviors, with random halves being asked the questions for a male and for a female. For all behaviors except having a full-time job, driving a car alone, and going on a date, some respondents volunteered that it was “never OK,” with rates below 10 percent for buying a lottery ticket, drinking beer or liquor, and buying beer, and above 40 percent for getting drunk on beer at home, being a regular smoker, and trying marijuana. Table 13-1 TABLE 13-1 Mean and Standard Deviation of the Acceptable Age for 15 Contested Behaviors, According to Ontario Adults Aged 25 or Older, 1996 Behavior Mean Standard Deviation Go out on a date 16.2 1.4 Buy a lottery ticket 17.4 2.3 Drive a car by himself/herself 17.7* 1.5 Get a full-time job, year round 17.7 2.3 Smoke a cigarette 18.0 2.4 Have sex with a girlfriend/boyfriend 18.4 2.2 Buy a pack of cigarettes 18.6 1.9 Have a drink of beer 18.8* 1.7 Try some marijuana 18.8 2.2 Become a regular smoker 19.0 2.6 Have drink of liquor 19.3* 2.0 Get drunk on beer at home 19.4 2.3 Buy a six-pack of beer 19.5* 1.7 Go to a bar with friends and drink enough to feel the effects 19.8* 1.9 Move in with a girlfriend/boyfriend 20.1 2.6 *Mean age significantly lower for a female to do this than a male. Differences between the genders were all less than half a year. Note that this is based on those who gave an age for the behavior (i.e., excluding those who said it was “never OK”). SOURCE: Paglia and Room (1998).

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Reducing Underage Drinking: A Collective Responsibility shows responses among those ages 25 or older among those who did give an age when those behaviors are okay. Acceptable ages to drink or purchase alcohol were in the upper half of the ages for the behaviors in question, ranging between 18.8 and 19.8. Thus the age of acceptability for buying a lottery ticket, driving a car alone, getting a full-time job, smoking a cigarette, or having sex with a girlfriend/boyfriend was lower than the age for having a drink of beer. Of the behaviors asked about, only moving in with a girlfriend/boyfriend had a higher age of acceptability than any of the behaviors involving alcohol. Table 13-2 compares the responses of Ontario teenagers and adults, grouped by age, about acceptable ages to try marijuana and initiate cigarette smoking, beer drinking, and buying a six-pack of beer (Room and Paglia, 2001). For all behaviors the normative age of initiation is gently curvilinear by age, with the lowest age given by those who are themselves at about that age (eleventh grade students usually would be 16 or 17). At the level of the “public norms,” measured as responses to a telephone survey (for the adults) or to items on a questionnaire (for the students), the variation between generations is fairly modest. For the two alcohol items, for example, the average difference between eleventh graders and the adults ages 40 to 54, roughly their parents’ generation, is about 21/2 years. The alcohol normative ages given by Ontario adults correspond fairly well to the legal minimum age for purchasing or drinking alcohol in Ontario, which is 19. However, the actual ages at which Ontario teenagers start experimenting with drinking alcoholic beverages is about five years younger. Among seventh graders (ages 12-13), 32 percent report alcohol use in the past 12 months, with 58 percent having used at some time in their lives; in ninth and eleventh grades, the proportions drinking in the past 12 months rise to 55 percent and 80 percent, respectively (Adlaf, Ivis, and Smart, 1997: Table 10 and Figure 57). These five years provide an ample arena for contests between the generations. However, the results in Table 13-2 suggest that younger experimenters with alcohol see themselves as breaking rather than conforming to the norms of their own age cohort. In the earlier teenage years, to drink is to do something one is not supposed to be doing yet. Tracks and Subcultures: Sorting and Differentiation in Adolescence Along with their functions of preparing every child for adulthood and holding different age-grades apart from each other and from the adult world, schools and other institutions for teenagers also function as major sorting devices in the course of sociocultural reproduction. By the early teenage years, the curriculum diverges for different students, and often students are divided into different streams, which are recognized by all as

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Reducing Underage Drinking: A Collective Responsibility TABLE 13-2 Mean (and Standard Deviation) of the Acceptable Age Given, by Grade in School (1997 Ontario Student Survey) and by Adult Age Group (1996 Ontario Survey)     Grade Adult Age Group Behavior Total 7 9 11 13 Total 18-24 25-39 40-54 55+ By a male: Smoke a cigarette 16.4 (2.5) 17.1a 15.9b 16.1b 17.1a 18.1 (2.4) 17.4 18.1 18.2 18.3 Try marijuana 16.3 (2.6) 17.7a 15.9b 15.8b 17.0a 18.9 (2.3) 18.5a 18.8a 18.5a 20.4b Have drink of beer 16.7 (2.6) 17.7a 16.4b 16.2b 17.3a 18.9 (1.6) 18.2a 19.0b 18.9b 19.0b Buy 6-pack of beer 18.0 (2.3) 19.0a 17.9b,d 17.6b,c 18.3d 19.6 (1.7) 18.7a 19.8b 19.7b 19.6b By a female: Smoke a cigarette 16.3 (2.9) 17.1a 15.9b 15.8b 17.1a 17.9 (2.5) 17.9 17.6 18.2 17.8 Try marijuana 16.3 (2.6) 17.2a 15.9b 16.0b,c 17.0a,c 18.6 (2.2) 18.1 18.5 18.6 19.2 Have drink of beer 16.8 (2.8) 17.7a 16.4b 16.2b 17.4a 18.6 (1.8) 18.3 18.6 18.8 18.5 Buy 6-pack of beer 18.1 (2.3) 19.0a 17.9b,c 17.6b 18.3a,c 19.3 (1.7) 19.0 19.2 19.6 19.3 N range: 448-948 57-186 130-288 187-337 71-149 280-577 49-83 102-210 70-172 34-113 NOTE: Means with the same superscript (a, b, c, d) are not significantly different at p < 0.05, based on the Scheffe comparison test. Thus, for instance, for smoking a cigarette there is no significant difference in the mean age given between seventh and thirteenth grade students and between ninth and eleventh grade students but there is a significant difference between seventh and ninth grade students and between ninth and eleventh grade students. SOURCE: Room and Paglia (2001).

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Reducing Underage Drinking: A Collective Responsibility having different fates in store as adults. Reactions to errors in marking state examinations illustrate what is seen as being at stake: students may have their “chances in life unfairly damaged” (Bright and Hinsliff, 2002). Although the sorting in the U.S. system is not necessarily final—for many, there are second and third chances—sorting schoolchildren into different schools or different “tracks” in the same school is also potentially fateful. Before they are teenagers, children have begun to sort themselves out into differentiated crowds and cliques. A 9-year-old child in the United States can usually give an accurate ethnography of the characteristics of those who can be found at recess at different corners of the playground. The American community high school may include adolescents from all parts of the community, but it has long been documented that in their social lives, the students are heavily differentiated and sorted by social class as well as by personal preferences and friendships (Hollingshead, 1961). Children and youth also construct their own subcultures, which often have substantial continuity across cohorts of children, as the Opies (2001) found for the playground songs and games of young schoolchildren. In adolescence there is not only a general youth subculture, but also a variety of more specific subcultural formations, built around sports, cars and other machines, music, arts, and other interests. Although adults often provide input into these subcultures, attempts to subject the activities to rigorous control are often resisted and evaded. Around the edge of the official adult-controlled version of events, there tends to be a lively social world run by the teenagers themselves. In the 20th century, styles of music and dancing have been particularly productive of subcultural differentiations not only between generations but among youth themselves (Polhemus, 1995; Thornton, 1995). These subcultures have become increasingly internationalized, as with the spread of raves. Cultural Variations in the Processes The existence of large cultural variations globally in the processes we have been outlining has been clear for a long time. The processes have some of the same content as the “rites of passage” analyzed by van Gennep (1960) in tribal societies. But such rites of passage as classically described typically take place in a well-defined and limited period, while the processes we are considering occur over a much longer time period and often with less clear temporal definition. Although, as has been remarked, “some have viewed the entire period of adolescence in modern cultures as analogous to the disorienting middle stage of van Gennep’s classic three-part scheme” of a rite of passage, that is, as “an extended period of transition characterized by uncertainty and confusion that eventually leads to the adult taking his or

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Reducing Underage Drinking: A Collective Responsibility her place in society” (Anonymous, 1997), it seems clear that there are variations both between and within modern cultures in the extent to which any such analogy would make sense. Cultural variations in expectations about the “social clock” often come into view in stark relief in particular circumstances in multicultural societies. For immigrants to the Nordic countries from Pakistan, for example, the custom may be for parents to make an advantageous marriage for their daughter at age 13. But in a Nordic context, such a practice is seen as shocking, so far outside expectations concerning the “social clock” that legislation must be passed and programs initiated to counter it (e.g., Ministry of Children and Family Affairs, 2001). Within the general frame of developed societies with European roots, the range of cultural variations in the processes tends to be more limited. The remaining differences, however, still have the capacity to shock. American teenagers are likely to be surprised to discover that the minimum age for a driver’s license is 18 in much of Europe, while Europeans tend to be shocked by the relatively low ages at which a teenager can be tried as an adult in the United States and put at risk of a range of penalties up to and including the death penalty. In some matters, the United States is at the low end in terms of ages at which youth can be put at risk of harm equivalent to adults. The United States remains one of two countries that has not ratified the U.N. Convention on the Rights of the Child, apparently in part over the minimum ages specified for enlisting in military service and for capital punishment. The age at which a person can be tried for a crime as an adult, rather than as a juvenile, is lower in many U.S. states than in European countries. On the other hand, with respect to minimum drinking age, the United States is at the high end internationally (see Table 13-3). No country has a higher minimum age, and few have an age as high as in the United States. At first sight, at least, the United States seems to be in a contradictory position on these matters. Perhaps one clue to the contradiction is the fact that the debate about minimum drinking age in the United States mostly revolved around and was decided in terms of traffic casualties. In an automobile-oriented culture, with often inadequate public transport that presses parents into service as the chauffeurs for children below the age for a driver’s license, the idea of raising the driving age has seemed impossible; raising the drinking age became the only feasible alternative for reducing the serious carnage from teenage driving. Table 13-3 makes it clear that Europe has tended toward a different solution to separating inexperienced driving and inexperienced drinking. The age for obtaining a driver’s license is higher in most parts of Europe than in most parts of the United States.

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Reducing Underage Drinking: A Collective Responsibility TABLE 13-3 Minimum Ages for Purchasing Alcohol, Purchasing Cigarettes, and Obtaining a Driver’s License, Countries of Europe and U.S. States   Alcohol Purchases Cigarette Purchases Driver’s License   European Countries U.S. States European Countries U.S. States European Countries U.S. States ≤15 1 0 8* 0 0 6 16 6 0 7 0 0 42 17 0 0 0 0 11 1 18 16 0 16 47 23 1 19 0 0 0 3 0 0 20 1 0 0 0 0 0 21 1 50 0 0 0 0 *No minimum age specified. Netherlands is counted as 16; this age limit is effective 2003. Note that a varying number of European countries are included because of limits in the underlying compilations. Minimum age specified for alcohol is the age at which some form of alcoholic beverage can be purchased for on-premise or off-premise consumption. Fractional minimum ages for U.S. driver’s licenses coded to the lower year; for example, 16 years 9 months is classed with 16. Ages are for full (not learner’s) licenses. SOURCES: For alcohol: World Health Organization (1999) and International Center for Alcohol Policy (2002). For cigarettes: World Health Organization, Tobacco or health: a global status report: country profiles by region, 1997. http://www.cdc.gov/tobacco/who/whoeupro.htm. For driver’s licenses, U.S.: http://golocalnet.net/drive (Orchard Park, New York: Golocalnet, 2002); Europe: http://www.theaa.com/staticdocs/pdf/allaboutcars/overseas/european_motoring_advice.pdf. (Newcastle-upon-Tyne, UK: Automobile Association, 2002). All sites accessed 7 October 2002. Cultural Variation in Meanings of Drinking and Drunkenness Differences at the General Cultural Level As physical commodities, alcoholic beverages have a range of use-values (Mäkelä, 1983) reflecting their different properties. As liquids taken into the body, they quench thirst. Cold, they can cool the body; hot, they can warm it. As a source of calories, they provide some sustenance. Traditionally, they were used medicinally; with the findings on their protective value for heart disease, this use is returning, although the net health balance from drinking in the population as a whole is negative. As psychoactive substances, they can act as a mood changer; at heavier doses, they can take one out of oneself, or be a means of psychic escape. Although these use-values can be distinguished from one another, when an alcoholic beverage is used for one purpose, its other properties are also carried along. To use wine as a food and source of calories, as was done

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Reducing Underage Drinking: A Collective Responsibility traditionally by Italian farm laborers, does not preclude it from also having psychoactive effects. On top of the physical properties of alcohol, and the use-values attached to them, is an extraordinarily wide range of cultural meanings ascribed to drinking, with their own range of use-values. For a majority of Christians, wine is a sacrament with a range of sacred associations. Sacramental wine is not supposed to intoxicate. Old Anglican prayer books therefore addressed the use of consecrated wine left over after communion. It could not be returned to profane status, but it was also not proper for the priest simply to drink it up, risking drunkenness. Instead, he was instructed to gather other communicants and drink the wine with them “reverently” on the spot (Church of England, 1662). A crucial use of alcohol, from the perspective of the harms associated with it, is the set of use-values surrounding intoxication from drinking. The “prized but dangerous” psychoactive effects of drinking heavily, as Steele and Josephs (1990) term them, are differentially sought by drinkers in different cultures. As the ethnographic literature has long taught us (MacAndrew and Edgerton, 1969; Room, 2001), there are also big cultural differences in comportment from a given level of drinking—often described, differences in the “disinhibition” associated with the drinking. The combined effects of these differences in drinking patterns and in cultural norms of drunken comportment can be quite dramatic: Time-series analyses of the relation between changes in average alcohol consumption and changes in homicide rates suggest that an extra unit of drinking pushes the homicide rate up twice as much in northern European countries such as Sweden as in southern European countries such as Portugal (Rossow, 2001). A scale of the degree of hazard in the patterns of drinking in a society has been developed, ranging as a first approximation from 1 for the least hazardous patterns to 4 for the most hazardous (Rehm et al., 2001; see Table 13-4). On this scale, Portugal, for example, is scored at 1, the United States at 2, Sweden at 3, and Russia at 4. Although the proportion of drinking occasions which are relatively heavy is factored into the scale, the scale does not include the dimension of demeanor while drunk, that is, the extent to which norms for drunken behavior allow for violence or other bad behavior. Nevertheless, cross-nationally this dimension appears to cluster with the dimensions included in the scale (Rehm et al., 2001). In a factor analysis of data from ethnographic records in the different frame of traditional tribal and village societies, Partanen (1991, p. 213) also found that violence was particularly associated with a pattern of intermittent but heavy drinking occasions. The scale has been used so far only at the level of societies as a whole, but the same kind of dimensions of variation exist within societies. In particular, there is some evidence that the social trouble per unit of drinking

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Reducing Underage Drinking: A Collective Responsibility TABLE 13-4 Proportion Drinking 5 or More Drinks on 3 or More Occasions in Past 30 Days, Proportion Drinking at All on 3 or More Occasions in the Past 30 Days, Ratio of These, and Minimum Drinking Age, European School Survey Project on Alcohol and Other Drugs (ESPAD), 1999 Country and Hazardous Drinking Score A. 5+ Drinks on 3 or More Occasions in Past 30 Days B. Any Drinking on 3 or More Occasions in Past 30 Days Iceland (3) 16 15 Norway (3) 24 23 Poland (3) 31 33 Finland (3) 18 21 Sweden (3) 17 21 Slovenia (3) 25 32 Latvia (3) 14 23 Ireland (3) 31 52 Macedonia (3) 9 15 United Kingdom (2) 30 55 Hungary (3) 12 22 Croatia (3) 12 23 Estonia (3) 14 28 U.S.A. (2) 10a 21 Denmark (2) 30 62 Russia (Moscow) (4) 16 34 Bulgaria (2) 11 25 Ukraine (3) 10 23 Malta (1) 22 52 Cyprus (1) 12 32 France (1) 12 33 Czech Republic (2) 17 49 Portugal (1) 7 24 Romania (3) 5 18 Slovakia (3) 8 30 Lithuania (3) 8 37 Greece (2) 9 49 *Rounding error resulted in ratio >1; reset at maximum possible (1.00). aDrunk 3+ times in past 30 days. bHas been drunk in lifetime, eighth graders. SOURCES: Drinking behaviors: Hibell et al. (2000); except U.S. data from Johnston et al. (2000). Hazardous drinking score: Rehm et al. (in press).

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Reducing Underage Drinking: A Collective Responsibility ties described by Beccaria and Guidoni (2002) around young men’s conscription in northern Italy feature plenty of heavy drinking. One of their informants noted that “you have to drink, to show incredible powers of endurance to alcohol.” But the attachment of the parties to an occasion that extends back in history, and features of the parties such as traditional drinking games, suggest that the parties do not constitute a new cultural innovation. The somewhat puzzling findings concerning attitudes and norms on drinking among adults in northern and southern Europe (Room and Bullock, 2002) suggest that differences in norms about how drunk one may get, and how one may behave at a given level of drunkenness, are not straightforward. But some customs in the north seem to stand out. No equivalent seems to exist elsewhere, for example, of the Norwegian tradition of russefeiring, in which each high school graduating class (with some pre-echoes in the graduating class from middle school) devotes the 17 days between May Day and the Norwegian national day to a drunken rite of passage, with negotiated rule breaking that is both individualistic and collectively organized (Sande, 2002). Quantitative evidence on the issue of cross-cultural variation in hazardous drinking patterns in Europe is available from the European Study of Patterns of Alcohol and Drug Use, or ESPAD (Hibell et al., 2000), which administered a common questionnaire (comparable in a number of items with the U.S. Monitoring the Future Study questionnaire—Johnston, O’Malley, and Bachman, 2000) to 15-year-olds in schools in a total of 30 countries in Europe. Table 13-4 shows some results from the 1999 samples of this study, along with results for tenth graders from the U.S. study. The countries listed in Table 13-4 are ordered according to the results in the third column of figures, that is, in terms of a ratio reflecting the proportion of drinking occasions for which respondents reported drinking 5+ drinks (in the U.S. data, being drunk). This might be taken as an indication of the extent to which heavy drinking occasions predominate as the drinking pattern among 15-year-olds. The United States falls at the median on this table in terms of this ratio, with about half as many respondents reporting being drunk at least 3 times in the past 30 days as those who report drinking any amount at least 3 times in the same period. Although there are some surprises in the order on this ratio (Lithuania, Romania, Russia, Slovakia, and Ukraine are unexpectedly low, and Malta somewhat high), the ratio generally follows the hazardous drinking scores assigned for the society as a whole (Rehm et al., in press). By this measure, then, there does seem to be some relation between teenage drinking patterns and the drinking patterns of the larger society. In terms of the actual proportion drinking 3 or more times in the past 30 days, the United States is tied for the fourth lowest position; in two of

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Reducing Underage Drinking: A Collective Responsibility the three societies with lower percentages, lack of resources is likely to be one factor keeping the frequency of drinking down. The United States also appears to be at the lower end of the distribution on proportions regularly drinking heavily, although no exact comparison on drinking 5 or more drinks is available (26 percent of U.S. tenth graders reported drinking that much at least once in the past 2 weeks). Compared to Europe, U.S. teenagers are less likely to drink regularly at all, and seem to be somewhat less likely to drink heavily on a regular basis. In several countries—the United Kingdom, Ireland, Poland, and Denmark—the proportion of teenagers drinking 5+ drinks on at least 3 occasions in the past month is substantially greater than the proportion of U.S. teenagers drinking that much at least once in the past two weeks. The last two columns in the table show responses in the different national samples on getting drunk. What it means to be drunk is a matter of cultural definition, and the responses are also affected by idiom and connotations in the local language, so comparisons should be made with caution. In particular, “drunk” may be tend to be defined in more extreme terms in wine cultures. In four societies—Finland, the United Kingdom, Denmark, and Ireland—half or more of the 15- to 16-year-olds report having been drunk in the past month; in the first three of these societies, along with the students in Moscow, one-third or more of the students report having been drunk by age 13. At the other end of the spectrum, having been drunk by age 13 is relatively uncommon in many of the wine cultures and parts of eastern Europe, and rates of having been drunk in the last 30 days are 20 percent or below in eight wine cultures—Croatia, Cyprus, France, Greece, Macedonia, Malta, Portugal, and Romania. U.S. tenth graders are less likely to report having been drunk in the past 30 days than 15-year-olds in many western European countries. On the other hand, the United States is further up the ordering in terms of early drunkenness, comparing the proportion of U.S. eighth graders who report ever having been drunk with the proportions of Europeans who retrospectively report having been drunk by the age of 13. Trends and Concerns About Teenage Drinking in Europe The ESPAD study also offers the broadest set of quantitative data on changes in teenage drinking in Europe, because the questions asked in 1999 in many of the countries involved also had been asked in an earlier survey in 1995. The general trend from 1995 to 1999 in many countries was for an increase in the proportion of 15- to 16-year-olds reporting drinking 5+ drinks on 3 or more occasions in the past 30 days (Hibell et al., 2000:71). The increased proportion was considerable in the three countries that al-

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Reducing Underage Drinking: A Collective Responsibility ready had the highest rates (Ireland, Denmark, and the United Kingdom) and in Poland and Slovenia, but there were also increases in five other countries, while the proportion stayed much the same in nine countries. No country had a substantial decrease. Youth drinking has become a general social and health concern in Europe. In fact, concerns about youth drinking have been the main vehicle for expressing concerns about alcohol problems in general at a continental level, such as in the European Union. A flurry of concern about “alcopops” (sweetened alcoholic drinks perceived to be aimed at youth) started in 1995 and brought the first serious attempt at public health-oriented action on alcohol issues within the European union structure (Sutton and Nylander, 1999). In early 2001, European Ministers of Health agreed on a “Declaration on Young People and Alcohol,” stating that “the health and well-being of many young people today are being seriously threatened by the use of alcohol and other psychoactive substances,” and setting goals, including reducing drinking and high-risk drinking substantially, delaying the onset of drinking among young people, and reducing pressures on young people to drink from alcohol advertising and other promotion (World Health Organization, 2001). Nevertheless, concern about youth drinking is generally less urgent in Europe than in the United States, and measures and programs to counter it have been generally soft and not particularly effective. The discussion about alcopops in Denmark did result in a law imposing a minimum age limit (of 15) for off-premise purchases of alcohol, which seems to have some effect (Møller, 2002). Countries that have traditionally had fairly restrictive alcohol controls (the Nordic countries other than Denmark, the United Kingdom, and Ireland) in areas such as bar and liquor store closing hours and days have continued to loosen the controls (Karlsson and Österberg, 2001), raising the effective availability for youth and others. In Ireland, which has seen an extraordinary rise in alcohol consumption (46 percent in 11 years), with high rates of drinking among teenagers (see Table 13-4), a Strategic Task Force on Alcohol (2002) has called for increased taxes and other measures. In the United Kingdom, the primary policy focus has been on “drunken yobs” (louts; Hinsliff, 2002) and “alcohol-related crime, disorder and violence” (U.K. Home Office, 2000), including proposals to increase regulation and legislation concerning underage drinking. But the government effort has lacked crucial components such as a scheme to provide “proof of age” documentation, a task that has been left in the hands of an alcohol industry organization (Portman Group, 2000). As in the example from Norway, harm reduction efforts are also common in much of Europe. Institutional legal liability for underage drinking is much less likely outside the United States.

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Reducing Underage Drinking: A Collective Responsibility Age Limits and Coming of Age Discourse and Choices Arguments and Issues in the Discourse About Underage Drinking An interesting study that has not been done would be to read and analyze the discourse in different societies about the minimum legal age for drinking and for other behaviors. Clearly, there is influence between polities on these matters: for example, the age of majority was lowered from 21 in many places in the 1970s, while there is currently a strong tendency to push up the minimum age for purchasing cigarettes. Turkey’s legal age of marriage is being raised from 17 for men and 15 for women to 18 for both genders, as part of a modernization of the civil code pushed forward in the process of applying for membership in the European Union. The code which is being replaced was based on Swiss family law in 1926, adopted as “the most modern code of its time” (Fraser, 2001). The lines of influence probably flow mostly from the center to the periphery, so that the discourse in the United States is not strongly influenced these days by provisions and arguments from elsewhere. One potential consideration in discussions about the minimum legal age for drinking would be the effect of alcohol on the physically developing body. This was a consideration in the recent proposal by a Canadian Senate committee for a minimum age of 16 for a legalized marijuana regime (Senate Special Committee, on Illegal Drugs 2002, pp. I, 166). Other potential considerations are the various ages at which understanding and judgment in different circumstances are considered mature, and how drinking and intoxication may interplay with these factors. Intoxication often enters into legal considerations about consent to sexual intercourse and about intent to perform criminal acts; for both of these issues, there is a minimum age at which a teenager’s self-governance is recognized. If a teenager is too young to be held legally accountable for the results of drinking, maybe he or she is too young to be drinking. In the United States, arguments defending a drinking age of 21 emphasize the higher probabilities of later drinking problems for those who start drinking earlier (e.g., National Advisory Council on Alcohol Abuse and Alcoholism, 2002, p. 51), although there is room for questioning the causal significance and relevance to the minimum drinking age of the relationships used in these arguments. Issues of the relation of the drinking age to other normative ages can also come into the discussion. For example, a consideration in raising the minimum drinking age from 18 to 19 in Ontario in 1979 was to move legal drinking out of the ages of high school attendance. As we have noted, the relation of minimum drinking age to minimum driving age and driving customs is particularly relevant in the United States; one argument that has been given for discounting European experience is

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Reducing Underage Drinking: A Collective Responsibility that “youth drive less frequently in Europe than in the U.S.” (National Advisory Council on Alcohol Abuse and Alcoholism, 2002:52). An important consideration with respect to minimum drinking age is the issue of how and in what circumstances drinking is to be initiated. A position paper of the National Youth Rights Association (n.d.) summarizes the main line of argument on this issue that has been used in the United States: “Drinking age laws discourage rather than encourage a transition period between youthful abstinence and adult use of alcoholic beverages,” writes journalist and sociologist Mike A. Males (1996:207). Under such laws, many young people learn drinking in unsafe environments, like basement keg parties. They use alcohol with the intention of getting drunk rather than as an accompaniment to food. Researchers say American young people engage in dangerous “binge drinking” far too often and far more often than some of their European counterparts, who learn to drink in the open. The United States should take lessons from cultures like those of Jews, Italians and Greeks, who traditionally focus on misuse of alcohol, rather than simple use of alcohol, as the source of problems. “Educational efforts should encourage moderate use of alcohol among those who choose to drink,” explains sociologist David J. Hanson (1996:45). There are several empirical problems with the line of argument as it is stated. The first is that, as Table 13-4 indicates, European teenagers are at least as likely as Americans to initiate drinking before the local legal age. Table 13-4 also suggests that the United States is about in the middle of the range of European countries when it comes to the proportion of teenagers engaged in drinking that—in U.S. terminology—is often called binge drinking. Furthermore, there is no clear relationship, viewed cross-nationally in the table, between the minimum drinking age and the proportion of binge occasions among teenage drinking occasions. As we have seen, there is also some evidence of a generational shift in teenage drinking patterns in southern Europe, moving toward more binge drinking. Perhaps most importantly, the evidence that a solution of “educational efforts” would have much success is not compelling at the level of the individual educational program (Paglia and Room, 1999), let alone at the level of the society. Examples of societies that have successfully changed their patterns on hazardous drinking and drunken comportment are hard to find (Room, 1992). Considering the development of amounts and patterns of drinking in western Europe in the past 50 years, Simpura (2001:11) concludes that changes in “qualitative features of drinking” may take decades and even longer to become visible. Some traditional qualitative features of drinking seem very persistent to change, even in the midst

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Reducing Underage Drinking: A Collective Responsibility of major quantitative changes in consumption levels etc. Therefore, the analysis of this report suggests that the natural time frame for changes in drinking patterns is a generation, rather than a decade or any shorter period. If this is accepted, it implies that efforts to prevent alcohol-related harm by measures targeted at drinking patterns will produce gains only in the very long run, if ever. On the other side of the argument, it must be acknowledged that there has been one substantial change already in drinking patterns in the United States over a period of about a generation—the shift away from drinking before driving. Given the U.S. culture’s dependence on the automobile, this has been a significant change, even if an incomplete one. But an effort to reduce rates of drinking before age 21 to insignificance seems to be taking on a much more difficult task, particularly in a cultural environment saturated in promotion of drinking in youth-oriented media, and in a legal environment where restrictions on alcohol advertising and promotion are increasingly suspect from a constitutional perspective (Hudson, 2002). Underage Drinking Can Be Reduced—But What Then? There is little question, from data predominantly from the United States, but also from Canada and Australasia, that changing the drinking age affects levels of alcohol consumption and rates of traffic crashes in the applicable ages and to some extent at lower ages (Wagenaar and Toomey, 2002). However, the effects on other health and social problems are less clear. A Danish study has recently found that instituting a minimum age of 15 for purchases for off-premise consumption had an effect on consumption levels (Møller, 2002). In this case, the effect also extended above age 15, which may have reflected a sensitization of Danish parents to watching over their children’s drinking as a result of the public debate about the measure. But stiffer policing of underage drinking presumably has its limits in a situation where alcohol is readily available to those over legal age. Despite much police pressure, marijuana—though not legally available—has not disappeared from the life of young American adults. In the case of alcohol, repression may in the end provoke a rebound, as Prohibition did among American youth in the 1920s and 1930s (Room, 1984). In the context of official repression, drinking—and indeed intoxication—became a symbol of a generational rebellion. As a member of that generation remarked, looking back, “drinking, we proved to ourselves our freedom as individuals and flouted Congress …. It was the only period in which a fellow could be smug and slopped concurrently” (Liebling, 1981:667). Even if there is no rebound, there will still be a substantial residue of drinking under the age of 21 in the United States at any time in the foresee-

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Reducing Underage Drinking: A Collective Responsibility able future. This leaves open the following question: What is the best way to handle the discrepancy—which exists in Europe as well as in the United States—between the actual ages at which teenagers start drinking and the age at which the behavior becomes legal? Age-specific prohibition is more likely to reduce the frequency of drinking than the amount drunk on one occasion. In fact, although a rigorous enforcement may result in fewer intoxicated occasions, it may well raise the proportion of drinking occasions that involve intoxication. Environmental strategies such as high taxes on alcohol and reducing the general availability of alcohol can be brought into play and will have some effect (Toomey and Wagenaar, 2002). But, again, the effect will have its limits. The general policy choices at that point are by now familiar from the world of illicit drugs, although there are differences in their application in the case of underage drinking. One choice is the “zero tolerance” model. Underage drinking is vigorously pursued, if necessary with urine testing, and those detected are punished, secondarily deterred, or “treated,” hopefully back into line. Public attitudes in the United States generally do not support the application of such an approach with anything like the rigor used for illicit drugs, except perhaps in connection with drinking and driving. A second choice is an institutionalized “patterned evasion” of norms. This is how marijuana smoking is handled these days in much of Europe and parts of the United States. If the young cannabis smoker does not insist on lighting up on the steps of the police station, but keeps the use within private space, he or she is generally left alone. The police, however, retain the possibility of a “drug bust” as a handy lever in the pursuit of their duties, which tends to mean that the strategy results in many arrests and police records, potentially on a discriminatory basis. Institutionalized patterned evasion was the traditional approach of American colleges to underage drinking before the last two decades. A third choice is a “harm reduction” strategy, which involves acknowledging the reality of youthful drinking in the course of making provision to reduce the harms associated with it. This third strategy is pursued by the Norwegian local police in dealing with russefeiring (Sande, 2002). Each year the elected leaders for that year’s celebration negotiate in considerable detail with the local authorities about which public rules are available to individual participants to be broken (with the achievement of breaking it marked by a trophy sign on the russefeiring costume). The adult world has made various unsuccessful attempts to eliminate russefeiring, but given that these have failed, there is no hesitation in falling back on minimizing the harm.

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Reducing Underage Drinking: A Collective Responsibility The approach to underage drinking by American colleges traditionally included some elements of harm reduction, along with the patterned evasion strategy. But in the past two decades, a harm reduction strategy has been becoming more difficult for colleges: to acknowledge that illegal behavior is occurring puts the colleges at risk of legal liability for adverse consequences. More generally, American culture seems to be uncomfortable with the uneasy compromises with disapproved behavior which harm reduction strategies often involve. Thus the trend seems to be toward the first choice. This is the policy choice that offers the best target for a potential future generational rebellion. As we have noted, Europe does not seem to be moving in the same direction in terms of policy choices. Although some young people, particularly in the United States, remain abstainers, drinking and intoxication seem to be involved in the process of growing up for many young people in all societies with European roots. One way or another, the damage from the intoxication to the drinker and to others can be reduced, but it is unlikely to be eliminated in the foreseeable future. Nor is it likely that state actions can succeed in cutting off all drinking below the age of 21. In these circumstances, there is a need to look not only at means of prevention of underage drinking, but also at means of handling it to minimize the adverse consequences. These adverse consequences would include any lasting stigma and its adverse effects on those found to be drinking. There is also a need for a greater understanding of the place of drinking and intoxication in the various subcultures and social worlds of young people. U.S. researchers and policy makers have much to gain from encouraging a greater internationalism in studying these issues. REFERENCES Adlaf, E.M., Ivis, F.J., and Smart, R.G. (1997). Ontario student drug use survey: 1977-1997. Research Document Series No. 136. Toronto: Addiction Research Foundation. Anonymous. (1997). Rite of passage. In J. Kagan and S. Gall (Eds.), Gale encyclopedia of childhood and adolescence. Farmington Hills, MI: Gale. Available: http://www.findarticles.com/cf_dls/g2602/0004/2602000456/p1/article.jhtml (accessed 20 May 2003). Aries, P. (1962). Centuries of childhood: A social history of family life. New York: Knopf. Beccaria, F., and Guidoni, O.V. (2002). Young people in a wet culture: The functions and patterns of drinking. Contemporary Drug Problems, 29, 305-334. Bright, M., and Hinsliff, G. (2002, September). Heads act on exam chaos. Available: http://www.observer.co.uk/politics/story/0,6903,792510,00.html (accessed 20 May, 2003). Cahalan, D., and Room, R. (1974). Problem drinking among American men. New Brunswick, NJ: Rutgers Center of Alcohol Studies. Church of England. (1662). Book of common prayer. Oxford: Oxford University Press. Fraser, S. (2001, October). Turkey revises male-dominated code. Available: http://www.fww.org/famnews/turkey.htm (accessed 20 May 2003). Gusfield, J. (1996) Contested meanings: The construction of alcohol problems. Madison: University of Wisconsin Press.

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