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The magazine for alumni and friends of Massey University.
Issue 14, April 2002

Professor Sally CasswellProfessor Sally Casswell and SHORE, the Centre for Social and Health Outcomes Research and Evaluation

Being a country’s pre-eminent authority on the sensitive area of drug and alcohol use carries its own responsibilities. It may also affect the company you keep.

When the Auckland-based SHORE centre, led by Professor Sally Casswell, was opened in November last year, the Prime Minister and a who’s who of decision-makers in the public health sector turned up to endorse the initiative. Just a few months later, the centre hosted Health Minister, Annette King, who announced a research partnership between SHORE and the Ministry of Health’s Public Health Intelligence Group, “ aimed at improving the health of New Zealanders”. The first major project will be a national population survey: more than 8000 people will be surveyed on drug use, both legal and illegal, providing an insight into who is most at risk of developing consequent conditions or diseases.

Casswell has been eminent in her field since the age of 21, as a postgraduate student at the University of Otago. Born and raised in England, she travelled by ship to New Zealand at the urging of an early mentor, psychologist Dr Jim Hodge. At Otago she chose the effects of cannabis for her thesis and acquired the first ‘licence’ to legally administer cannabis in New Zealand. “I had a freezer full. The aim was to analyse the cognitive effects of the drug on volunteers, often selected according to their physical size.”

Naturally she was subject to intense media interest. “Yes, I achieved a relatively high profile. That has proved to be useful.” Journalists quickly recognised her ability to demystify the complexities of drug and alcohol

research. Casswell, for her part, regards sharing her knowledge and research results with the public as part of her job. “Not least because they have often contributed to the research and, if the research influences policy, then they may stand to benefit.”

For her PhD, this time at the University of Auckland, she shifted her attention to alcohol use. The move was timely. Little was known about how New Zealanders used alcohol, and change was in the wind – the Alcohol and Liquor Advisory Council would be formed in 1976. Research projects were proposed, most to be funded by the Medical (now Health) Research Council. The University of Auckland, with Sally Casswell, won key contracts and set up an Alcohol Research Unit. Then in 2002 came the transfer to Massey University and the creation of the centre for Social and Health Outcomes Research and Evaluation . SHORE has more than 20 social science researchers on its staff and works in partnership with Mäori research group Te Ropu Whariki.

Casswell is an advocate of what she terms ‘multi methods’. “You never stick to one approach. You take an issue, which may be an important problem for New Zealand, and apply as many research methods as necessary to solve it.”

She sees how society handles the question of access to alcohol as symptomatic of wider social, political and ideological trends. “For example, when New Zealand moved to neo-liberalism in the 1990s, laws on alcohol were also liberalised including the review of the Sale of Liquor Act. Debate shifted, deregulation was discussed, then there was wine in supermarkets, the lifting of restrictions on television and radio advertising.”

What drives her? Is it the desire to make a difference, to change minds and policy and improve outcomes? Or is it the research itself, the lure of discoveries waiting to be made. “I ask myself that, too. On the one hand, there is nothing quite like the arrival of a new set of statistics with new data to analyse. It’s a fresh pleasure and the tricky bits are great fun. But I couldn’t imagine doing it, for example, to sell a product. It wouldn’t fit what I see as my purpose in life, to contribute to the community.”

SHORE and Te Ropu Whariki maintain a well trained (and appropriately paid, says Casswell) field team of multi-lingual survey interviewers who operate a computer-assisted telephone interviewing (CATI) laboratory. The system allows high-quality social and health survey data to be collected from a range of population groups. A current project is a telephone survey, in four Pacific languages, of Pacific Island drinking patterns.

Casswell particularly values SHORE’s partnership with Te Ropu Whariki. Helen Moewaka Barnes says it is important to ensure you are accountable, that the people you have worked with are among the first to learn the results. Casswell adds that she has learnt much from Barnes’s group about ensuring that research on delicate social issues is rigorous but also respectful of people. ”We know that Mäori, for example, have sometimes felt ‘over-researched’.”

Casswell is also Chair of the World Health Organisation Alcohol Policy Strategy Advisory Committee, and SHORE researchers have managed WHO projects. In Geneva, Casswell recently met (at his request) “a representative of the largest alcohol producer in the world, to discuss some WHO concerns. These really are real world issues.” (However, she adds that the Asia-Pacific region is becoming the world’s biggest and most lucrative market for alcohol).

At home, Casswell has her own concerns, as the mother of a teenager. Which drug would she least like to see him using? “Cigarettes.” And the obvious question, impossible not to ask: Does she drink? Yes, most nights, around two glasses of wine. That’s it.”

SHORE, the Centre for Social and Health Outcomes Research and Evaluation, is dedicated to relevant policy and community research and evaluation. The centre is committed to the Treaty of Waitangi as the framework for achieving social and health goals and works closely with Te Ropu Whariki, a M¯aori research group directed by Helen Moewaka Barnes.
Between them, the two teams are expert in alcohol and other drugs, M¯aori health, the effects of location on health, M¯aori identity, youth mental health, and nutrition and body image. Their methodological expertise includes the design and implementation of social survey research, programme evaluation, community action research, kaupapa M¯aori research and the use of a qualitative methodologies including discourse analysis.

Wayne Mowat: Massey University in Auckland is embarking on a three-year study of the effects of alcohol marketing on young people.

The World Health Organisation has recently highlighted the problem globally and New Zealand’s Health Research Council is funding the Massey study to the tune of $600,000. The work will be done by the Massey Centre for Social and Health Outcomes Research, and its director, Sally Casswell, says it’s the first of its kind in the world. Reporter David Stevenson has enlisted some thoughts from young people themselves and he talks to Professor Casswell.

Casswell: New Zealand is particularly interesting because we had a major policy change in the early ’90s which allowed alcohol brand advertising on radio and television for the first time. We’ve had some pretty sophisticated television and radio campaigns since then. We’re now getting exposed to a wide range of marketing, as is happening internationally. Internet marketing, for example. So we know young people grow up very much exposed to images of alcohol.

David Stevenson: Daniel, Paul, Terri and Kate are your average 15- and 16-year-olds. In a completely unscientific bit of research I talked to them about their attitudes towards alcohol and alcohol advertising.

Girl: Um, when I was probably like 11 or something, I started looking at them. You don’t really notice them until then. I started noticing the Speights ads because everyone kind of, like, jokes about them at school.

Boy: Good on you mate.
Stevenson: Now you’re drinking beer. What about the alcopop ads and things like that?
Boy: Alcopop?

Girl: Alcopop?
Stevenson: Well you know, the sweet drinks?

Boy: Dolly water.

Girl: In the ads, people who drink that stuff look cool. If I didn’t see the KGB ads and the Vodka Cruiser ads and all that sort of thing, it would probably just be the straight vodka that you mix for yourself. But we see the good alcohol on TV.

Boy: And they’re safer than a whole bottle so your parents are more likely to give you, like, a box or like a six pack of KGBs than give you a bottle of vodka.

Casswell: The industry needs to continually recruit new consumers of alcohol because they’re continually losing people from the other end, as they die or mature or get mortgages or whatever. So they’re obviously interested in not losing their consumer base. We’ve certainly seen increases in the amounts young people are drinking over the past 10 years. And yes, I think it’s quite clear that some of the products that have been developed and some of the ways of marketing are very attractive to young people. There’s a lot of sponsorship. If you go onto some of the beer company websites, you’ll see linkages with radio channels and radio programmes that are very much targeted at young people. You’ll see there’s sponsorship of big events like the Big Day Out. So there’s very clearly explicit linkage with youth culture. Alcohol brands are really like other brands that kids identify with. In a sense they promote their own identity by being identified with the brands.

Boy: Especially people younger than us, they’re into, like, Lion Red and stuff all the time. You see them with boxes of Lion Red.

Girl: The man’s drink.
Girl: It’s getting really common amongst younger people now. You see a lot of kids on the street drinking…11 and stuff, out on the streets and, like, just drinking. They don’t tell their parents, they say they’re going to the movies. I don’t know where they get the alcohol from…

Stevenson: So do you think they’re being influenced by the advertising?
Girl: The ads look cool to drink.

Boy: And they’d probably be influenced by older people.
Boy: Like us, yeah. Because we drink they think, oh, sweet.

Casswell: The project will take three years. The Health Research Council is interested because some of the ideas that we gain should be useful for thinking about health promotion and ways of talking to young people about healthy responses. They might also be useful for the policy debate around alcohol marketing and whether what’s happening now is appropriate or not appropriate.

Girl: Whenever a new drink comes out, the new ad comes out. And, like, they change alcohol to make it seem you’ll be smarter and have more fun if you have it. There’s the ad where they get in a plane with all these rich people and go and have fun and say the beer made them.

Casswell: What we’re trying to do in this research is get a picture of the way they and their friends are seeing the world. Through very, very careful, very detailed analysis of what they say, we hope to understand whether there’s a relationship between the kind of images they’re receiving and the values they’re incorporating into their daily lives. What is the relationship between the way they see the world and the way they see alcohol and the way they see their relationships with their peers and so on? So, it’s trying to get a sense of their understanding of their world and the meanings they bring to what they see and hear. We’re looking at their truth, if you like, and what it means for them.

Stevenson: Do you go back to them to see whether their ideas change?

Casswell: Yes, we’re starting with groups of young people at different ages. We’ll go back to them several times over the three-year period, hoping to pick up the way in which their ideas progress. These are very key years, from 13, 14, 15, 16 and 17, in terms of building a relationship with alcohol. These are the years when young kids are generally starting to want to drink, and see their peers drinking.

Girl: Like, when a new drink comes out, you kind of look at that and you think oh, I’d better try that. Because otherwise you can’t really walk into a liquor store and go, oh, just having a look around. So we see it on TV and think, oh, I’d better get someone to get that for me so I can try it. That’s the only way under 18 people can actually see the alcohol and the stuff that’s new.

Stevenson: Does it differ from culture to culture within New Zealand or from socio-economic groups?

Casswell: That’s one of the things we’ll be looking at. We will look at both M¯aori and non-M¯aori in this research and yes, I would say that there are most definitely cultural and socio-economic differences in norms around drinking.
Stevenson: Can the results from a New Zealand survey such as this be relevant to other countries?
Casswell: Yes, certainly they will be. We know that in many ways New Zealand is very similar to other industrialised countries, and increasingly youth culture is a global culture.

Boy: Like that new Lion Red ad, they’ve got the dudes and the chicks on it, sweet.
Boy: Alcohol makes your butt look better, that’s what they portray on the ads too.
Boy: Pick up the chicks.

Abridged transcript from National Radio’s In Touch With New Zealand.

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