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This study aims to explore the barriers that prevent students from moderating their drinking by comparing attitudes towards moderation in a wet (New Zealand) and dry (Vietnam) drinking culture and examines whether these barriers can be understood by applying an ecological framework.

A qualitative survey involving a written vignette was conducted with a sample of 226 and 277 undergraduates from New Zealand and Vietnam, respectively. Data were analysed using qualitative content analysis.

The analysis reveals that students perceive several barriers to moderate drinking at the intrapersonal level (e.g. positive attitude towards drinking), interpersonal level (e.g. peer pressure) and environmental level (e.g. socialising activities), suggesting that an ecological framework is useful for understanding drinking cultures. The response variations between the two countries provide novel insights into cultural differences in students’ perceptions, with external factors being more important and influential in the wet culture and internal influences being of more concern in the dry culture.

The findings highlight that students in the wet drinking culture do not take personal responsibility for their drinking and suggest that social marketing should move beyond individualistic approaches and towards the disruption of drinking cultures/practices, in pursuit of a healthier drinking culture.

This study provides novel insights into the barriers and facilitators of moderating drinking. Further, the findings demonstrate the value of a holistic ecological framework for understanding student drinking cultures. The comparison between two diverse cultures revealed how insights from one culture can help to understand deep-seated practices and meanings in another.

The purpose of this paper is to identify factors associated with drinking patterns during pregnancy.

A rapid evidence assessment was undertaken, scanning multiple databases for studies examining factors associated with alcohol consumption in pregnancy. Studies were included if they stratified data according to quantity of alcohol consumed and identified relevant associated factors. Drinking patterns were classified as light/moderate and heavy/binge.

In total, 15 studies were included (N=7 light/moderate; N=15 heavy/binge drinking). Factors associated with alcohol consumption during pregnancy included: smoking, age, SES, marital status, pre-pregnancy substance use and parity. While few studies reported an association between heavy/binge drinking and maternal mental health, none of the studies included explored the association between mental health and light/moderate drinking.

Relatively few studies have looked at the association between psychological characteristics of women and their drinking patterns. There is a lack of articles examining light/moderate drinking in pregnancy compared to heavy/binge drinking. Moreover, there is marked variation in how alcohol use is measured. Further studies are needed to increase understanding of the association between psychological factors and patterns of drinking during pregnancy, and how health professionals might support women in this context.

The authors expand on previous work by examining two different patterns of alcohol consumption in pregnancy, rather than alcohol use simply as an isolated concept. The two groups were found to differ in a number of demographic and social factors. This information could be used to aid healthcare professionals in targeting specific interventions to those women most at risk.

The purpose of this paper is to explore the meso-level social forces that influence moderate drinking in young women’s friendship groups through the application of social capital theory.

A qualitative inquiry was undertaken utilising peer-paired and small focus groups to explore young women’s drinking choices within their existing friendship groups. Guided by emic and etic perspectives, friendship groups were analysed to inform archetypical representations that illustrate group-level social capital exchanges.

The approach led to identifying four social capital and drinking archetypes. These archetypes indicate social capital-led “influencers” and “followers” and highlight the displays of capital practised by young women in alcohol consumption contexts.

The social marketing insight drawn from this study of young women’s drinking behaviours will inform social marketers on future strategic directions about how they can use alternative methods to segment the social market of young female drinkers and develop value propositions that will motivate them towards adopting or maintaining moderate drinking practices.

This study contributes to social marketing theory by demonstrating the worth of social capital theory as an alternative lens for social marketers to apply in explorations of group influences that shape behaviour. The research findings in the paper demonstrate how deeper theorisation provides rich insight into the meso-level, complex behavioural influence which effect young women’s alcohol consumption.

This paper aims to understand how experiential value can generate awareness, image, perceived quality and loyalty to the moderate drinking brand. Electronic games are increasingly used by social marketers in an attempt to support target audiences uptake of social behaviours. However, little is known of the value this creates for target audiences and its impact on the uptake of a social behaviour brand.

A survey of male adolescents (n = 137) was conducted to test proposed relationships between experiential value and consumer-based brand equity dimensions. The research tested the game “Don’t Turn a Night Out into a Nightmare” that was developed by the Australian Federal Government as part of a social marketing campaign. Data were analysed using linear regression and MANCOVA.

The findings indicate that there are significant relationships between consumer-based brand equity dimensions for the social behaviour brand of moderate drinking, indicating relevance of a commercial marketing theory for social marketing. Furthermore, findings show that different combinations of experiential value dimensions have an impact on different components of consumer-based brand equity. These findings indicate that when social marketers are developing electronic games, they must create different combinations of value in game play to achieve awareness, positive image, high perceived quality and, ultimately, loyalty to a behaviour.

Social marketers seeking to use electronic games to influence the uptake of behaviour brands such as moderate drinking must provide a more complete value package.

This paper is the first to examine how experiential value can influence the creation of brand equity for a social behaviour brand.

Social stress and alcohol/arrack drinking are interrelated and vary across the sub cultures or cultures around the world. This study aims to examine relationships between social stress and arrack drinking patterns among Muslim, Hindu, Santaland Oraon communities in Rasulpur of Bangladesh.

This study was conducted in Rasulpur of Bangladesh. In this region arrack produced from palm and date juice and arrack drinker of four ethnic communities is available round the year. Out of 760 male arrack drinkers, 391 samples (109 Muslim, 103 Hindu, 89 Santal and 90 Oraon) were randomly selected and were interviewed with semi‐structural questionnaire.

The results of multinomial logistic regression analysis revealed that there were significant differences in and relationships between social stress and arrack drinking pattern among the communities studied. Results suggested that the 2‐35 times higher risks of Hindu and Muslim's social stressors than the Santal and Oraon were significantly related to their arrack drinking pattern.

Although the findings of this study have been successful in understanding cross‐cultural variations in and relationships between social stress and arrack drinking patterns among the ethnic communities, further empirical study is needed into how coping or social support influence the relationships between the variables studied. In spite of this the findings may apply in formulating social policy and programs to reduce arrack drinking in the context of social stress in rural Bangladesh.

This paper is original in linking of theory, policy and practice in the context of social stress at reducing arrack drinking pattern in rural Bangladesh.

The purpose of this paper is to review the conceptual and methodological challenges of a J-shaped association between alcohol consumption (AC), coronary heart disease (CHD) and all-cause mortality. In associated papers in this journal, Skovenborg et al., 2021 reviews the evidence for the J-shaped curve, and Ellison et al., 2021 examines the advantages and drawbacks of Mendelian randomization studies of the J-shaped curve.

A number of methodological problems are common in observational research in general, and some of the methodological problems suggested for the J-shaped alcohol-CHD-associations are discussed. The extent of the methodological problems in studies of the J-shaped curve is reviewed, and the possibility that the J-shaped curve is an artifact created by reverse causality and residual confounding is discussed. Further, the issue of interaction with drinking pattern and type of alcohol is discussed.

Imprecise categorization of alcohol intake information seems to have had little effect on the J-shaped alcohol-CHD-associations, nor has it affected the ability of these studies to show increasing mortality from a range of causes with increasing AC. The problem of “sick quitters” has been resolved by large studies using lifelong abstainers or infrequent drinkers as reference group. Many studies lack information on drinking patterns with regard to regular, moderate consumption versus binge drinking. Stratified analyses by important risk factors for CHD have not significantly changed the J-shaped association observed in most epidemiologic studies.

Potential biases and residual confounding probably do not overcome the J-shaped alcohol-CDH-association observed in most epidemiologic studies; however, the existence of a J-shaped curve is challenged by some degree of uncertainty. The actual review together with the associated papers by Skovenborg et al., 2021 and Ellison et al., 2021 offers a possibility to “update your priors” and achieve greater certainty when giving your patients information on the pros and cons of alcohol intake.

Background: The central issue of this paper is whether the intuitive relation between problematic drinking and seeking professional help holds. To shed light on this issue an ecological study is done in which the relation between different drinking patterns, alcohol‐related harm, and help‐seeking behaviour at the neighbourhood level of Rotterdam, The Netherlands is examined. Two questions are posed:1. Are there geographical differences in drinking patterns, alcohol problems, problem drinking, and number of alcohol clients within the city of Rotterdam?2. Is there a relation between drinking patterns, alcohol‐related harm, and help‐seeking behaviour at the neighbourhood level?Methods: Ecological analyses are conducted based on individual data originating from a survey and person‐based registers. Respondents to the survey were classified as abstainers, light, moderate or excessive drinkers, and were classified as having alcohol‐related problems and/or being a problem drinker. Person‐based registers were used to obtain data on the number of ambulatory and clinical alcohol clients in Rotterdam. The number of ambulatory and clinical clients measured help‐seeking behaviour.Results: The intuitive reasoning that the more problematic drinkers, the more professional help is sought does not stand. No association was found between the number of alcohol clients and the percentage of excessive drinkers and problem drinkers at the neighbourhood level. Large differences between neighbourhoods in prevalence of excessive drinking, alcohol‐related problems and problem drinking were found. The number of alcohol clients, however, varied much less between neighbourhoods. A notable result is that the higher the percentage of abstainers, the lower the number of alcohol clients in a neighbourhood.Discussion: It was concluded that in all neighbourhoods the number of problem drinkers outnumbers those seeking professional help, indicating a friction between need and supply of help with respect to problematic drinking. It is hypothesised that besides drinking behaviour and drinking‐related problems individual, as well as social and cultural factors, play a role in the process of help‐seeking behaviour.

Social marketing has been applied to alcohol education, changing adolescents’ knowledge, attitudes and intentions toward binge drinking for the better. However, there remains limited research in the social marketing literature examining multi-stream models considering social-contextual factors and individual differences in the applied context of adolescent drinking.

A multi-group structural equation model approach was applied to analyze cross-sectional self-report data from 2,234 (mean age = 15.3 years, 48.7 per cent female) Australian adolescents. Based on the theory of planned behavior, the role of attitudes, subjective norms and perceived behavioral control in adolescents’ binge drinking intentions were examined. Potential moderating effects of peer and parent drinking behaviors and drinking status were tested.

The model explained 47.3 per cent variance in intentions for drinkers and 31.6 per cent for non-drinkers. Subjective norms were more strongly related to intentions than attitudes. Peer and parent behavior modified those associations, and drinking status further moderated interaction effects. Under conditions of favorable norms and attitudes, family and friends’ behavior fuels adolescents’ binge drinking intentions. Conversely, exposure to modeling of non-drinking peers and parents can bolster negative binge drinking beliefs.

Social marketing programs seeking to change adolescent drinking culture should include peers and parents whose drinking behavior modified associations between attitudes, norms and intentions to binge drink.

This study investigated how social-contextual factors (midstream) and drinking status influence relationships between adolescents’ attitudes, norms and perceived behavioral control (downstream factors) and their intentions to binge drink. These moderating effects have not previously been examined within the theory of planned behavior framework, and limited previous research has examined multi-stream models.

This paper outlines a pilot study that was undertaken in Australia in 2011 that combined social marketing with education. An intervention targeting 14‐16 year olds to influence attitudes and behavioural intentions towards moderate drinking was developed and tested. Game On:Know alcohol (GO:KA) is a six‐module intervention that is delivered to a year level cohort in an auditorium. GO:KA combines a series of online and offline experiential activities to engage (with) students.

Following social marketing benchmark criteria, formative research and competitive analysis were undertaken to create, implement and evaluate an intervention. The intervention was delivered in one all boys’ and one all girls’ school in April and June 2011, respectively. A total of 223 Year 10 students participated in GO:KA with the majority completing both pre‐ and post‐surveys. Paired samples t‐tests and descriptive analysis were used to assess attitudinal and behavioural intention change.

Attitudinal change was observed in both schools while behavioural intentions changed for girls and not boys according to paired samples t‐testing. Post hoc testing indicated gender differences.

The lack of a control group is a key limitation of the current research that can be overcome in the 20 school main study to be conducted in 2013‐2015.

The current study provides evidence to suggest that a combined social marketing and education intervention can change teenage attitudes towards moderate drinking whilst only changing behavioural intentions for female teenagers. Analysis of the intervention provides insight into gender differences and highlights the need for a segmented approach.

Prevalence rates of older adults (OA, 50+) with high-risk alcohol use are rapidly growing. Barriers to intervention persist for OA. Mobile interventions, specifically short message service (SMS, also known as text messaging), provide an opportunity to overcome such barriers. The purpose of this paper is to explore the acceptability and preliminary effectiveness of four SMS intervention conditions compared to mobile assessment only among OA (50–65 years old, n = 49) who drink at high-risk levels compared to younger adults (YA, 21–49 years old, n = 102).

Within and between age group differences at baseline and end-of-treatment (12 weeks) were explored. Generalized linear modeling was used to test age by receipt of any SMS intervention (compared to assessment only) effects across health outcomes. Effect sizes and visual analyses were generated to assess for age by type of SMS interactions.

Both age groups reported intervention satisfaction. Two-thirds elected to continue receiving SMSs after treatment concluded. Descriptively, SMS groups demonstrated reduced drinking across age groups at end-of-treatment compared to mobile assessment only, though slightly larger effects were found for YA than for OA. Age significantly moderated the receipt of any SMS intervention only for depression (i.e., older age weakened the therapeutic effect). Of all the SMS types, tailored messages outperformed the other conditions on drinking outcomes for both age groups. Depression, craving and alcohol problems responded to gain-framed messages among OA and loss-framed messages among YA.

The findings of this paper suggest that SMS is acceptable and potentially effective across age groups. Further adaptation of SMS across age groups could enhance its effectiveness.

This is the first paper to explore the impact of older age on the efficacy of text messaging as an intervention for hazardous alcohol use.