Fox talked about how drinking culture mediates the effects of alcohol consumption. Alcohol is disinhibitory but the particular things that are disinhibited seem strongly culturally mediated. She gives the example of that social norms around public urination change in the drunken state as compared to sober, but not norms around public defecation. And so we see a lot more of the former than the latter.
For a more recent and worse example, consider the differences in drunken comportment in German culture, and that of some recent migrants to Germany. Why do some drunken crowds of young men think that sexual assault is fine, and other drunken crowds really really don't?
Fox's paper drew a fair bit of media critique last week on the back of an article in Addiction by Nicki Jackson and Kypros Kypri. Among the things they didn't like:
- The study didn't have ethics committee approval.
- But ethics committee approval wouldn't really here have been an issue: they had focus groups convened by market research companies, and Fox is a consultant, not an academic. Further, while Jackson & Kypri note that ethical approval boards vet proposals for methodological quality, the vast majority of research undertaken even at universities will have no such prior vetting: you don't need to go to a review board if you're just running regressions on established data, for example.
- Fox downplays links between alcohol and violence, ignoring studies showing correlations between alcohol and violence across "a broad range of cultural contexts."
- But their source doesn't really show that. Rossow looks at alcohol and homicide across 14 European countries, broadly grouped as southern Europe, central Europe, and northern Europe. Before reading for their results, I tried to guess what Fox would have predicted. She noted that Anglo-Saxon cultures take drinking as bacchanal, where more of the rules are suspended where southern European ones have drinking more successfully integrated into life and where rules aren't suspended. So, following Fox's thesis, I'd expect the weakest links in Southern Europe.
- What does Rossow find? The weakest links are in Southern Europe. And Rossow's conclusion talks about the differences in drinking culture between the Nordic countries, where drinking to intoxication is more common, and Southern Europe, where drinking is just a general part of dinner. Rossow writes: "Furthermore, there also seem to be cultural differences in drinking context, particularly drinking with meals, when comparing northern and southern European countries, which may add to the potential of alcohol consumption leading to violent behaviour."
- It is ... strange ... to cite Rossow in an anti-Fox piece. I'd have thought Rossow's findings entirely consistent with Fox's thesis. Note that I'm not endorsing Rossow's method here: it's a pooled cross-section that only has alcohol sales and a constant on the right hand side: surely a host of omitted variables affect both homicide and alcohol consumption. But if you're going to cite it...
- Kypri goes on about limitation of trading hours in Newcastle and how that reduced harms; nothing about how 24-hour licensing in Manchester (UK) only affected the times of harms, not the quantity of harms. I don't know about the police procedure changes that he and Fox are arguing about, but I do note that Newcastle's downtown and waterfront have substantially gentrified - I would have expected things there to have cleaned up regardless of licensing times.
- They critique her recommending of education strategies for minors and parents, noting that education programmes have been pretty ineffective.
- Again, this is a bit odd. Fox spends a lot of time talking about how existing programmes are generally pretty terrible and how they could be improved. I suppose it could be impossible for any of them to work, but the critique remains strange.
- While recommending increases in the alcohol purchase age as "evidence-based", they ignore the work by Boes and Stillman showing that the NZ change in the alcohol purchase age had no effect on harms. I wonder if the public health side will ever notice that piece.
I'd be a bit surprised if Fox didn't come out swinging here.