Pressure to change drinking and help seeking over the course of 26 years: Cohort effects from the National Alcohol Surveys

Individuals with alcohol problems frequently receive pressure to quit or change drinking behavior. National trends of pressure to change drinking between 1984 and 2005 show an overall decrease in pressure from family, friends, work, police, and physicians. However, these trends do not identify the potential influence of cohort (i.e. year of birth) on pressure or how pressure relates to help seeking. The present study examines the influence of cohort on pressure and help seeking from the National Alcohol Surveys from 1984-2010 (N=25,455). Representative in-person and telephone interviews were collected approximately every five years. Measures include past year pressure to change drinking from six sources (spouse, family, friends, work, police, and physicians), past year help seeking for alcohol problems, demographics, and heavy alcohol consumption. Cohort comparisons, after controlling for age and period, show that individuals born after 1974 were more likely to receive pressure than those born between 1955 and 1974. Additionally, among those that received pressure, those born between 1955-1964 were more likely to seek help for alcohol problems compared to younger cohorts. The higher incidence of pressure among cohorts born after 1974 may have been influenced by environmental prevention efforts (such as MADD) that target younger drinkers and create normative practices that discourage destructive drinking. Interestingly, the younger drinkers were less likely to seek help than an older cohort (1955-64). Further study of drinking practices, pressure, and help seeking are needed in addition to identifying how specific prevention strategies and policies affect pressure and help seeking among different groups.