“Beer before liquor, never been sicker; liquor before beer, you’re in the clear” is a rhyme I learned in college. The message was clearly effective, as many of my friends knew this rhyme as well, and some of us used it to remind ourselves to be vigilant when drinking. An effective public-health message is one that infiltrates common culture, is easy to remember and hopefully influences the public’s lifestyle, according to the American Heart Association. This approach is the one that the health community at Penn should take in addressing the consumption of hybrid drinks — those, like Four Loko, that combine alcohol with caffeine.
A University of Florida study surveyed the decisions of individuals who had consumed hybrid drinks. It found that the combination of the caffeine’s stimulant and the alcohol’s depressant decreased people’s ability to perceive their own impairment from alcohol consumption. This decreased perception led them to engage in riskier behavior than those who had consumed only alcohol. Individuals were more likely to ride in cars with intoxicated drivers and injure themselves physically, and there were increased reports of sexual victimization. In other words, alcohol alone impairs decision-making, and hybrid drinks impair it even more. We increase the chances that we will make very risky decisions — yet we remain unaware of the consequences.
As a result of the high-risk behavior that these drinks are associated with, some states — including New York, Washington and Michigan — have banned the sale of hybrid drinks in stores. While this prohibition limits the availability of brands like Four Loko and Sparks, it does not limit the risky behavior associated with their consumption. Ban or no ban, college students will still combine their vodka with Red Bull and their rum with Coke, whether the drinks are mixed in a can (like Four Loko) or in a bucket (per house-party protocol).
If a change in behavior is what the public-health community is after, it needs to employ an effective public-health message. The “beer before liquor” mantra effectively sticks in the minds of college students. Of course, we can’t depend solely on the simple ubiquitous presence of these quips to change the behavior of all college students. But the fact that these messages stick in students’ minds at all provides an access point — a chance for the public-health message to affect students when they are making a decision about drinking. And that decision may start a chain and affect the decisions of other students. It is a hopeful approach but one that Penn already has the infrastructure to employ with its “Ask us why” posters.
You’ve seen those posters all around campus. They say “Sleep. Ask us why” or “Have safe sex. Ask us why” or — my personal favorite — “Graduate. Ask us how.” Those popular posters resonate because they send short, provocative, memorable and even funny messages that get students thinking and wondering, “Why?” (“Why would I ask you why I should sleep? Don’t I know the answer to that? Don’t I know I should have safe sex?”). The posters tell students to do something they intuitively know they should do but, for some reason, don’t always act accordingly.
Thus, if the University is interested in getting students to think about their behaviors regarding the consumption of hybrid drinks, it should use the “Ask us why” posters to do it. Perhaps a message like “Jack and Joe are better off alone. Ask us why.” (Jack refers to the alcohol in Jack Daniels and Joe refers to the caffeine in coffee.) I’m sure some marketing student could come up with a better quip than I can, but the point is to send a message that gets students thinking about behaviors they know are risky but still engage in. The University already has the infrastructure in place to send this message. Let’s use it. Who knows? With the use of the “Ask us why” posters, perhaps “Jack + Joe = your foe” could become as ubiquitous as “beer before liquor” in the college drinking scene. It’s worth a try.
Ashley Hopkins is a 2009 College graduate currently pursuing a master’s degree at the Yale School of Public Health. Her e-mail address is ashley.hopkins@yale.edu.
