Alcohol Quitting Management: Perspectives on Undergraduate Students' Experiences

Received: 13-Apr-2025, Manuscript No. JDAR-25-146439;;Accepted Date: May 06, 2025; Editor assigned: 15-Apr-2025, Pre QC No. JDAR-25-146439 (PQ); Reviewed: 29-Apr-2025, QC No. JDAR-25-146439; Revised: 06-May-2025, Manuscript No. JDAR-25-146439 (R); Published: 12-May-2025, DOI: 10.4303/JDAR/236447

Introduction

Humans discovered naturally occurring alcoholic beverages some 10,000 years ago that fermented on their own. Later, these beverages evolved into three main types: liquor, beer, and wine. Alcohol can be considered the oldest psychoactive drug and has permeated many cultures worldwide [1]. Nowadays, alcoholic beverages are widely known and most frequently consumed globally for relaxation and stress reduction [2]. Controlling alcoholic beverages has therefore been established as a global strategy to reduce problems caused by alcohol consumption, with the goal of reducing the per capita consumption of alcohol by 10 percent by 2025 [3]. The challenge in addressing the problem is that alcohol consumption is deeply rooted in cultural values and traditions in many societies, coupled with the growth of the alcohol production industry through globalization. Governments often face conflicts of interest related to the production and trade of alcohol. Even in Thailand, a predominantly Buddhist country where consuming alcoholic beverages is against the 5th precept, a 2021 survey found that the current prevalence rate of drinkers is 28.00 percent, a slight decrease from 2017 (28.41 percent), but the number of new drinkers has doubled. In 2017, new drinkers constituted 3.00 percent of the population, whereas in 2021, they made up 6.00 percent. The majority of new drinkers are male. “New drinkers” are a population group that needs to be monitored each year because they may grow to be regular drinkers, heavy drinkers, or even alcoholics. The increase in new drinkers can significantly impact the prevalence rate of current drinkers [4]. Breaking down the details, it was found that in Thailand, there were 15.9 million people aged 15 years and over who drank in the last year (2020), accounting for 28.0 percent of the population. Regionally, the northern region had the highest rate of new drinkers (33.1 percent), while the southern region had the lowest rate (16.6 percent). Interestingly, the southern region also has the highest proportion of people who have never drunk alcohol (73.33 percent) and the fewest new drinkers. Most importantly, this region has continuously had the highest proportion of people who have stopped drinking since 2004 [5]. The abovementioned data suggest that if new drinkers in the southern region are school-aged, they are likely university undergraduates who used to drink but have now quit. Understanding their reasons and methods for quitting can provide important guidelines and role models for encouraging more new drinkers to quit. Therefore, a study titled “The important conditions for alcohol quitting management: Perspectives from undergraduate students in southern thailand” was conducted to identify key conditions for managing alcohol quitting and to develop an effective model for this process. The results of this research will provide valuable information for developing, implementing, enforcing, and monitoring measures to help new school-age drinkers effectively quit alcohol both nationally and globally in the future.

Literature Review

Urbán, Kökönyei, and Demetrovics discovered what motivates individuals to choose to drink or refuse alcoholic beverages [6]. It arises from a person’s management, cognition, and decision-making processes, together with their perception and expectations of outcomes from drinking alcoholic beverages, which are internal stimuli. There are also external stimuli, such as past alcohol experiences or current living conditions, that affect the cognitive process and can change the expectation of the results of drinking alcohol. For example, if a person expects positive results from drinking alcohol, their motivation to drink increases. Conversely, if a person perceives the consequences of drinking alcohol to be negative, they will avoid drinking. This aligns with Flay and Petraitis [7], who believed that people and the environment interact. Therefore, the cause or factor that influences the behavior of using or refraining from using drugs among teenagers is not due to any single factor but is caused by three different groups of factors: Group 1: Attitudinal influences, which are factors from the cultural environment that surrounds the individual in terms of values, including religion/culture, policy changes, independence, deviance, education, health, social acceptance, and beliefs about desired health and knowledge, as well as the opportunity to receive information, which affects knowledge or expectations. Group 2: Factors from within the individual (intrapersonal influences) include: 1) social competencies that come from educational skills (academic skills), social interaction skills (social interaction skills), and general social skills (general skills), which affect social skills (social skills); and 2) self-awareness that comes from ego integration, feelings of self-worth or inferiority (self-esteem/derogation), and self-image, which affect self-determination. Group 3: Social factors (interpersonal/social influences) or influences from outside the individual (social situation) are important and have the most significant impact on a person’s behavior. They consist of 1) the behavior and attitude of other people, which is part of social learning that comes from parents, adults, media, and friends; and 2) social ties that come from family, school, religious beliefs, and friends, which affect motivation to comply with norms, social perception, and motivation to act. This leads to beliefs that are social standards and affect decisions or intentions to practice health behaviors. Therefore, the various self-management factors mentioned above will affect the perception of self-efficacy, attitude, belief, and perception of social norms, leading to the presence or absence of alcohol drinking behavior among teenagers. This is consistent with Patrick and Schulenberg [8], who found that protective behavior from drinking alcohol is a specific cognitive and action management process to reduce alcohol consumption. There is also the Theory of Triadic Influence (TTI), which was developed to explain the relationship between adolescent health and substance use. This theory integrates factors influencing behavior from many different theories to provide a comprehensive explanation of behavior related to the health of teenagers. According to TTI, the decision to engage in any behavior arises from assumptions derived from multiple theories, which divide the factors influencing risky behavior into three types: factors within the individual (intrapersonal influence factors), social context influence factors, and cultural environmental influence factors. All three types of factors are interrelated. They are classified according to three factors: 1) Factors within the individual are related to genetics and personal personality, consisting of four aspects: self-efficacy in refusing to drink alcoholic beverages, inclination to drink, social anxiety, and seeking challenges. 2) Factors from the social context are related to the personality and behavior of role models during adolescence, which can cause imitation and affect teenage behavior in different ways. They also incentivize teenagers to change their behavior. This consists of three aspects: social norms regarding abstinence from drinking alcohol, having friends who stop drinking alcohol, and the cessation of alcohol consumption by family members. 3) Factors from the cultural environment are related to culture, which affects attitudes and influences a person’s feelings, thoughts, or valuation of something important. This consists of four aspects: Attitude towards quitting drinking alcoholic beverages, expecting good results from alcohol quitting, values of not drinking alcoholic beverages, and knowledge about the consequences of drinking alcohol [9-11]. This classification is consistent with the future-oriented model developed by Seginer and Manajna [12], which incorporates motivational elements as an input into the display of knowledge and leads to the determination of behavior as shown in the Figure 1.

Figure 1: The future orientation three-component model.

Gerhardt also explained that individuals attempt to control their behavior by employing various management methods to solve arising problems, set goals, and exert self-control to maintain desired behaviors and eliminate unwanted ones [13]. This approach contributes to future success. 

From the theory discussed above, it is evident that future-oriented management is a crucial component influencing success and serves as an essential quality enabling individuals to grasp societal principles, evaluate and rectify their own negative behaviors, particularly regarding alcohol consumption, and strive towards positive future objectives.

Research Objective

To study the conditions for abstaining from alcohol consumption among undergraduate students in the southern part of Thailand.

Research methodology

This research examined the conditions for quitting from drinking alcohol among undergraduate students in the southern part of Thailand using qualitative research methods. The study employed in-depth interviews with undergraduate students and group discussions with committee members-current or former student organization or undergraduate student club committees from each faculty of universities in the southern region, totaling 12 locations. Specifically, participants included informants who had used to drink alcoholic beverages but had now quit for at least 12 months. Each group consisted of 10 people, resulting in 20 participants per university, totaling 240 informants (120 students and 120 student organization committee members).

Methods

Management and governance

A research advisory group was established with representatives from the university, hospital, local government, and academic peers.

Setting

The study was conducted in 12 universities located in the southern part of Thailand.

Sampling and recruitment

Individual participants were recruited from voluntary undergraduate students at 12 universities in southern Thailand. Coordination was done with the presidents of student clubs in each faculty to select volunteers who had previously consumed alcoholic beverages but had stopped drinking for at least 12 months to participate in the research. Each university had 10 faculties, with one volunteer selected from each faculty, totaling 120 individuals who had quit drinking for at least 12 months.

Focus group participants were recruited from voluntary current or former student organization committee members, including student club committees for each faculty at all 12 universities in the southern part of Thailand. Coordination was carried out with the president of each university’s student organization to select volunteers who had previously consumed alcoholic beverages and had quit drinking for at least 12 months to participate in the research. Ten students were selected per university, totaling 120 participants. All participants were advocates for vulnerable groups, as required by the ethics committee. Verbal informed consent was obtained before providing further details of the study. Participants were not required to provide their names but were asked about their academic year. They received a modest cash payment for expenses.

Individual interviews

Following recommended methodology, individual interviews were intentionally brief (around ten to fifteen minutes) and were conducted inside available meeting spaces for student organizations, ensuring privacy and silence. Interviews were not recorded to encourage participation. They were based on a semi-structured format with open-ended questions about alcohol cessation management. Questions were adapted flexibly based on participants’ responses, such as: “Are you aware of the effects of drinking alcohol?”, “What do you perceive as the benefits of alcohol quitting?”, and “Do you have any other concerns?” Contemporaneous notes were taken on paper, capturing responses verbatim as much as possible. Recruitment continued until saturation of themes was achieved.

Focus group

Following recommended methodology for focus groups, sessions lasted 60-90 minutes and were conducted in private, silent meeting spaces available for student organizations. The focus groups utilized a semi-structured interview format with open-ended questions focused on alcohol cessation management, mirroring the approach used in individual interviews. Each group was facilitated by four researchers: two coordinators who welcomed participants, explained the study objectives and methodology, and ensured confidentiality, and two assistants who assisted with note-taking and logistics. Discussions were transcribed and independently verified, supplemented by contemporaneous notes. The coordinator encouraged active participation and concluded each session by summarizing key themes discussed and ensuring participants were informed about accessing study results.

Data analysis

The researchers conducted an initial content analysis of free-text responses in the individual and focus group interviews by counting the number of university students who mentioned specific topics such as alcohol quitting. In a more detailed qualitative analysis, four researchers independently coded the write-ups of individual interviews and focus group transcripts. A series of discussion meetings were held to refine these coding categories, and a shared analytic framework was developed based on methods by Chantavanich, Buosonte, Patton, Miles and Huberman, Gummesson, Holt and Thorpe, and Saldaña 14-20. For coding the transcripts, it was necessary to go through them line by line and paragraph by paragraph, looking for significant statements and codes according to the topics addressed. The researchers compared the various codes based on differences and similarities and sorted them into categories. Finally, the categories were formulated into 5 themes.

The researchers used three levels of coding. Level 1 coding examined the data line by line and made codes based on the language used by the subjects in the individual and focus group interviews. Level 2 coding involved comparing coded data with other data and creating categories that condensed the Level 1 codes. Level 3 coding described the basic social psychological processes 21, which represented the central themes that emerged from the categories. Disagreements between the researchers’ individual interpretations were resolved through discussion.

Results

Demographic characteristics

Table 1 (individuals) and Table 2 (focus groups) show the characteristics of the sample. Overall, 78% of the sample were men, with 50% in their third year. The researchers estimated that 83% of the sample had a comprehensive understanding of data from surrounding university students’ experiences regarding conditions for alcohol quitting management, while 14% had a moderate understanding, and 3% had a limited understanding.

Table 1: Demographic characteristics of sample for individual interviews in 120 participants.

Table 2: Demographic characteristics of sample for focus groups in 12 locations.

Main conditions in alcohol abstinence

Participants in the study reflected apparent indications of the main conditions for alcohol quitting management from the data sources (see Table 3). Each condition will be discussed both in groups and individually, accompanied by supporting quotes. The documents were submitted to two assessors for validation.

Table 3: Main conditions identified for the alcohol quitting management.

Main emerging themes

The framework below illustrates the main themes identified from the data sources. The interpreted data will be compared with existing literature (Table 4). After coding the data, elements exhibiting similar patterns or characteristics were clustered. Clustering is a strategy used to enhance understanding of a phenomenon by grouping and conceptualizing objects with shared patterns or characteristics. Following a review of the codes and categories, agreement was reached on their classification. The qualitative analysis revealed five themes from the data gathered through individual and focus group interviews. University students emphasized the importance of “self-control,” “attitude,” “future expectations,” “motivation,” and “self-efficacy perception” in their experiences with alcohol abstinence management.

Table 4: The three-level codes for five themes.

Self-control

Self-control is an action that demonstrates a person’s ability to manage themselves by choosing to engage or refrain from behaviors with reason and patience. This ability is often developed through experiential learning and observation, aiming to achieve desired outcomes and avoid adverse consequences. For instance, controlling oneself from quitting drinking alcohol may stem from concerns about its health effects and a commitment to learning to refuse it effectively.

Attitude

Attitude toward reduction refers to a mental characteristic where a person experiences satisfaction or dissatisfaction with something based on their approximate knowledge about the subject and understanding its benefits or harms. This understanding aids in maintaining self-esteem and avoiding negative outcomes. While attitudes are typically stable, they can change due to environmental influences, experiences, and learning. Factors influencing attitude change include the desire to serve as a role model, the need for social acceptance, and personal reactions to the taste and smell of alcoholic beverages.

Future expectation

Future expectation involves the capacity to think, anticipate outcomes, and make long-term predictions based on understanding potential positive and negative consequences. It entails devising action plans to achieve favorable outcomes and prevent undesirable consequences in the future. This includes aspirations for academic success, financial planning, adherence to regulations and laws, and conformity to social norms in pursuit of a promising future.

Motivation

Motivations for reduction are the internal forces that drive individuals to pursue their goals, often influenced by desires and temptations that stimulate actions. This process involves being motivated by challenges, competition, or emulation, which serve as driving forces in personal growth. Examples include honoring commitments, striving to overcome criticism, seeking inspiration from those who have quit drinking alcohol, and conforming to the norms of one’s social group.

Self-efficacy perception

Self-efficacy perception is the belief in one’s ability to manage and act effectively in anticipated situations. This belief influences thoughts, feelings towards others, self-motivation, and actions. It includes the conviction that quitting drinking alcohol can prevent injuries, reduce violence in society, and enable adherence to recommendations for quitting alcohol.

Implications for the alcohol quitting management model

Five key findings from this study include participants’ successful experiences in alcohol quitting based on personal relevance and the importance of trust in interpersonal relationships (Figure 2).

Figure 2: Alcohol quitting management model.

Discussion

Previous research studies in management of alcohol quitting

Previous research studies in management of alcohol quitting in higher education tend to focus on student alcohol abuse and related problems, preventing and impact to students. A number of studies have shown that produce small effects at reducing alcohol use and changing alcohol expectancies [22-24]. However, most of these studies involve students who drink alcohol rather than those who have never consumed it. Given the established outcomes of alcohol quitting, it is now necessary to examine the processes of managing alcohol quitting among students who have previously consumed alcohol but have not done so in the past year. This exploration aims to understand the underlying factors influencing these conditions, which arise from the decisions of university students to quit alcohol. These insights not only provide suggestions for students’ quitting alcohol but also enrich the theoretical framework for understanding the behavior of quitting alcohol. Leveraging the theoretical support of self-control, attitude, future expectations, motivation, and self-efficacy perceptions, the study found that participants who quit alcohol enjoyed life to the fullest. They expressed experiencing things appropriate for their age by stopping drinking alcohol, stating that upon graduation, they envisioned the best possible future. We agree with this perspective and also believe that university students can quit alcohol through self-control, attitude adjustment, future expectations, motivation, and self-efficacy perceptions. Among these concepts, it is worth mentioning the importance of recognizing the significance of life activities.

To begin with self-control, the results of this study indicate the importance of alcohol quitting, as daily variations in self-control demands are associated within individuals with subsequent decreases in the regulation of alcohol consumption and the ability to navigate social interactions and sustain goal-directed behavior [25,26]. This finding is further supported by Hiller, who found that individuals capable of self-control can avoid negative behaviors, whereas a lack of self-control leads to negative behaviors [27]. Additionally, Stautz, summarized that low self-control is associated with increased alcohol consumption [28].

The theme of “Attitude”: Verešová and Mala found that attitudes can profoundly impact a student’s success in education. Students with a positive attitude are more likely to take an active approach to their learning, seeking opportunities to engage with their knowledge [29]. They are also more likely to be proactive in seeking help when needed, which can improve their academic performance and lay a foundation for success. Other research has also indicated that students’ attitudes significantly affect learning outcomes [29-31]. Instrumental attitude refers to the rational or cognitive aspects associated with a particular behavior, such as believing that quitting binge drinking is healthy [32]. Attitude toward preventing drinking alcohol [33], can be an important target for interventions aimed at changing drinking behavior [34].

In conclusion, a student’s attitude can significantly impact their potential for success, particularly in proactive management of alcohol cessation. Encouraging students to set realistic and achievable goals, embrace challenges, foster a growth mindset, develop positive relationships with lecturers and friends, practice self-care, and celebrate successes can all contribute to cultivating a positive and successful mindset. It is also vital for students to seek support when necessary.

The theme of “Future expectation”: Lawson, et al. and Elfina and Andriany found that college students who have future expectations are more likely to persist and graduate [35,36]. Being conscious of these expectations encourages actions that lead to fulfilling future education and career goals [37]. This supports previous research by Bunpanya and Bhanthumnavin [38], which identified that university students’ reasons for not drinking, quitting drinking, and attempting to quit derive from their own motivations. They cited aspirations for their future, such as the desire for a good and respectable job.

The theme of “Motivation”: Moely and Ilustre found that students with a clear understanding of the benefits to themselves experience increased motivation, leading to improved cognitive learning [39]. Other research has also shown that motivation is a critical initial step in any action or behavior change; for example, motivation to drink alcohol was negatively correlated with actual drinking behavior, indicating that lower motivation to consume alcoholic beverages corresponds to reduced alcohol consumption [40,41]. This confirms that individuals seeking to overcome alcohol addiction must have high motivation. Motivation often stems from the desire to lead a healthy life, influencing behavioral changes crucial to the cessation process. Therefore, before initiating the process of alcohol quitting, most individuals possess at least one strong motivation to stop drinking. Thus, students’ motivation is a crucial factor influencing alcohol cessation management.

Furthermore, regarding the theme of “Self-efficacy,” Brown, et al. demonstrated that self-efficacy contributes to academic success because individuals with high self-efficacy beliefs actively work towards achieving goals [42]. Extensive research has explored students’ self-efficacy and achievement, with results indicating that students who attribute their past successes internally due to high self-efficacy are likely to perform well in the future. Similarly, research by Kamonpornmongkol found that individuals with high self-efficacy set ambitious goals, exert more effort in managing alcohol cessation, and persevere in their efforts [43].

Conclusion

Experiences in alcohol quitting are associated not only with setting achievable short- and long-term goals, which are key to academic success and social acceptance, but also with positive impacts on students’ physical and mental well-being. This study argues that self-control, attitude, future expectations, motivation, and self-efficacy perceptions are crucial for achieving success in alcohol cessation management. The findings reflect the experiences of university students in southern Thailand regarding the essential conditions for managing alcohol cessation. It would be presumptuous to assume that students in other regions and countries share identical perceptions regarding the mental and physical health benefits of alcohol quitting. However, it is likely that many of these sentiments are common among university students worldwide.

Author Contributions

Performed the data collection, statistical analysis, and wrote the first draft of the manuscript. All authors contributed to the conception and design of the study and manuscript revision, read, and approved the submitted version. 

Conflict of interest 

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

This project was partially financially supported by the office of the permanent secretary of the ministry of higher education, science, research and innovation.

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Copyright: © 2025 Putwimon Chocharat. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.