FOR IMMEDIATE RELEASE

Contact:
Michael Haines, Director
National Social Norms Resource Center
815.753.9745

DeKalb, IL (March 13, 2006)— A recent press release issued by the American Medical Association (AMA) makes a number of sensational statements based on highly questionable poll data and quotes the president of the AMA as concluding, "Spring break is broken. What was a traditional time to relax and take a break from college studies has turned into a dangerous binge-fest."

It is irresponsible of the AMA to make baseless statements that may inadvertently lead students, parents, and administrators to perceive that high-risk drinking among college students—whether on spring break trips or not—is more prevalent than it really is. Research has consistently shown that students who overestimate the prevalence of high-risk drinking are at increased risk for alcohol-related negative consequences (1-2). By fostering such misperceptions, the AMA may actually be placing students at greater risk of harm. Surely this does not serve to promote the public health.

Even a casual reading of the AMA release suggests that its poll was slanted to serve a particular advocacy agenda, and that both its methodology and analysis were so questionable as to render any of its so-called findings without scientific merit.

Consider, for example, the fact that the "key findings" reported for 2 of the 10 survey items bear the following asterisked notation:

"These questions were left to the interpretation of the respondent. Based on the wording of other questions in the poll, the AMA assumes reckless behavior is associated with sex and binge drinking. The AMA assumes outrageous behavior is associated with public nudity, dancing on tables/bars and participating in drinking contests." [Italics added.]

In almost every instance, a close examination of the AMA's "key findings" raises serious questions about the validity of its poll, with the result that much of its "data" is so imprecise as to be meaningless.

Consider these examples (the AMA "findings" are in quotation marks, with comments following):

• "A majority (74 percent) of respondents said women use drinking as an excuse for outrageous behavior."
  Note that respondents are not reporting on their own personal behavior, but rather on their perception of women in general. (Research shows that individuals' perceptions of peer high-risk behavior are notoriously inflated.) Thus, the AMA survey question is not even remotely a measure of the actual incidence alcohol-related "outrageous behavior"-which, as the AMA admits, is not defined for respondents, in violation of basic survey methodology.
• "An overwhelming majority (83 percent) of women had friends who drank the majority of the nights while on spring break." [Italics added.]
  Note once again that respondents are not reporting on their own personal drinking behavior, but rather that of friends. Beyond this, numerous questions of interpretation arise: Were these friends possibly boasting of something did not occur? If not, what age were they? Were they of legal drinking age? Were they of legal drinking age in their chosen spring break location? What quantity did they drink? Over what period of time did they drink?
• "More than half (59 percent) know friends who were sexually active with more than one partner."
  Note yet again that respondents are not reporting on personal behavior, but rather that of others. How do we (or the respondents) know that such reports are credible, and not, to some extent, unwarranted boasting? While being sexually active with more than one partner may be viewed as undesirable by some, it is not illegal. Given that intimate sexual contact bears some potential risk of STI, it would be more interesting to know, from a public health standpoint, what percentage of sexually active women on spring break trips self-reported the use of protection during intimate sexual contact.
• "One in five respondents regretted the sexual activity they engaged in during spring break, and 12 percent felt forced or pressured into sex." [Italics added.]
  Note the precipitous decline in the data figure when respondents report on their own behavior. Still, "regretting sexual activity engaged in" is a measure so vague as to be meaningless: an affirmative response to this question might very well mean that a single encounter was simply not pleasurable. However, that 12 percent of respondents "felt forced or pressured into sex" is not a trivial finding. It should be noted, nevertheless, that the vast majority (i.e., nearly 90 percent) of respondents engaged in consensual activity, which is a positive message that should be promoted.
• "Almost all (92 percent) said it was easy to get alcohol while on spring break."
  What percentage of respondents actually obtained alcohol? What percentage said it was easy to obtain alcohol but refused? What percentage of respondents was of legal drinking age at the time of their spring break trip? What percentage of respondents was reporting on a spring break trip to a location where the legal drinking age was under 21?
• "Two out of five women agreed access to free or cheap alcohol or a drinking age under 21 were important factors in their decision to go on a spring break trip." [Italics added.]
  Again, note the precipitous decline in the data figure when respondents report on their own behavior and motivation. Cheap alcohol or a lower drinking age are not the chief motivation for the clear majority of college women when selecting a spring break location.

Contrary to what the AMA would have us believe, spring break does not appear to be broken.

The data in the literature suggest that the vast majority of college students do not, in fact, participate in any kind of spring break trip. The last year for which data appear to be available, researchers estimated that approximately 1 million U.S. college students took some form of spring break vacation (3). Given that total enrollment in post-secondary institutions at that time was about 14 million (4), only about 7% of college students could therefore be said to engage in this kind of travel. What these data indicate, therefore, is that more than 9 out of 10 college students do not take any kind of spring break trip, in all likelihood choosing to use this time to relax with family and friends, or to work.

Shoddy science and transparently misleading scare tactics not only discredit those who employ them, they also make the job of many thousands of dedicated college health professionals and administrators more difficult. They may also be placing students at greater risk of harm.

It is time for the leadership of the American Medical Association to recognize this fact.

References

1. Perkins, H. W. "Social Norms and the Prevention of Alcohol Misuse in Collegiate Contexts." Journal of Studies on Alcohol, Supplement No. 14, pp. 164-172, 2002.

2. Perkins, H.W., Haines, M. P., Rice, R. "Misperceiving the College Drinking Norm and Related Problems: A Nationwide Study of Exposure to Prevention Information, Perceived Norms and Student Alcohol Misuse." Journal of Studies on Alcohol, 2005, 66: 470-478.

3. Mattila, A. S., Apostolopoulos, Y., Sonmez, S., Yu, L., Sisidrahain, V. "The Impact of Gender and Religion on College Students' Spring Break Behavior." Journal of Travel Research, 2001, 40:193-200.