Throughout history, alcohol have been produced and consumed by humans and it is a socially accepted factor in todays society. Consuming alcohol can be an enjoyable experience. However, excess consumption can lead to a serious range of health problems. There are several social cognition models’ aimed to change disruptive health behaviour. Albert Bandura developed social cognitive theory (SCT) proposing that behaviour depend on the environment and the observations of others (Eysenck, 1998). It was later influenced by Rotter (1954) social learning theory that emphasis in expectancy and reinforcement value (Eysenck, 1998). Bandura incorporated this to the SCT and developed reciprocal determinism. Proposing that behaviour is based on the interaction between personal factors, the environment, and behaviour (Eysenck, 1998). Changing one factor will influence the others contributing to changing a health behaviour. For instance reducing alcohol consumption as discussed below.

Alcohol

Every year thousands of people in the UK die prematurely due to excess alcohol consumption (Royal College of General Practitioners, 1986). Yet, alcohol is a legal substance. Excess alcohol consumption can lead biological defects such as chronic diseases, risk of impotency, heart attack, liver problems, increased risk of various cancers and high blood pressure (NHS Direct, 2012). Alcohol is a common component in incident of suicides, accidents and murders (Blum, 1987). In addition, it can lead to social harms such as violence, vandalism, inappropriate behaviour, family issues, ¬nancial difficulties, unwanted sex, and occupational problems (House of Commons, 2012). Rise in alcohol intake heighten the risk. (House of Commons, 2012)

The UK Health Departments propose that men should not consume more than three to four units and women no more than two to three units a day on a regular basis (House of Commons, 2012). One unit is the amount of alcohol an adult can process in an hour. It is the equivalent to 10 millimetres of pure ethanol (Drinkaware, 2011; as cited House of Commons, 2012). Consuming over 15 gram ethanol a day increase the risk of hospitalization, alcohol related death, alcoholism and intoxication (Romelsjo & Leifman, 1999). The majority of people that have alcohol related health problems are not alcoholics (NHS, 2012). Consuming more than the recommended unit in one session is termed binge drinking (NHS, 2012). This translates to eight or more unit in one session for men and six or more for women (NHS, 2012). The liver is able to filter the alcohol when consumed in moderation, excess drinking over a longer period can cause liver disease.

Alcohol consumers have an increased risk of death compared to abstainers (Romelsjo & Leifman 1999). The risk increases when the alcohol consumption increase (Romelsjo & Leifman, 1999). There is evidence that excessive drinkers are aware of the harm they are causing yet some increase their consumption (Bennett et al. 1998).

The government tried to reduce the alcohol consumption via; demand reduction by taxation, higher sentences for offences under the influence, regulating advertisement, restricting availability and increasing the legal drinking age (The World Health Organization 1988). In addition, encouraging appropriate consumption through health promotions targeted at reducing alcohol.

Social cognitive theory

The SCT propose that reciprocal determinism determine behaviour. It incorporates the interaction between personal factors, environment, and behaviour (Eysenck, 1998). The environment aspect of the diagram either facilitates or inhibits behaviour by incorporating previous experiences. A person will engage in activities that they know from previous experience will reward or positive reinforce them and avoid activities associated with punishment (Eysenck, 1998). Observation and modelling others will trigger the learning for which behaviour is rewarded or punished (Bandura et al,. 1963).

The personal factor includes personal characteristics, emotions, knowledge about the behaviour, possessing the skill for accomplishment, self-efficacy, expectation, self-regulation, observational learning and reinforcement (Redding, et al., 2000). Self-regulation control behaviour to obtain goals based on self-observation and personal standards (Eysenck, 1998). Self-efficacy can predict and changing health behaviour. It refers to an individual’s confidence in their ability. The level of self-efficacy depends on accomplishment, experiences, persuasion and external observations (Eysenck, 1998). For instance, an individual would be successful giving up drinking if they observed others success and the belief to accomplish their goal.

Individuals with low self-efficacy have poor expectancies of accomplishment (Redding, et al., 2000). This is associated with alcohol abuse and increase consumption (Stud, 1995; as cited Evans, & Dunn, 1995). A person must have the belief that one’s action will have the desired outcome or they will not be able to resist temptation (Bandura, 2004). High self-efficiency facilitates success and expectancies to do so (Redding, et al., 2000). Compared with low self-efficiency, high self-efficiency individuals have greater opportunity to succeed (DiClements et al., 1985; as cited in Eysenck, 1998). Schwarzer (1992) proposed that in order to change behaviour and obtain a healthier lifestyle the focus should be on increasing the self-efficacy. Past research show that alcoholics that stopped drinking on their own had higher self-efficiency compared to those that relapse (Vaillant 1995; as cited in Bandura, 2004). Those with high self-efficacy are less inclined to relapse and abuse alcohol in stressful situations (Marlatt & Gordon, 1980; as cited Florentine & Hillhouse, 2003). Burling, Reilly, Moltzen, and Ziff (1989) conducted a treatment to increase self-efficacy on inpatients with alcohol abuse. Interviews conducted after discharge assessed relapse and self-efficacy. Results showed that self-efficacy increased during treatment and was higher among abstainers than relapsers. Abstainers increased their self-efficiency during treatment. Yet, they had lower self-efficacy than relapsers initially. This demonstrating that low self-efficacy can be reversed and lead to successful outcome (Burling, Reilly, Moltzen, & Ziff, 1989).

Reducing alcohol consumption depends on the level of motivation that is determined by self-efficacy (Eysenck, 1998). In addition, it also depends on the level of outcome expectancy (Eysenck, 1998), cost and benefits (Bandura, 2004). For instance if an individual considers social approval and a healthier lifestyle as important and know that this could be obtained by not consuming alcohol they will be more inclined to not consume alcohol. Glanz et al, (2002) conducted a program to teach student in the 11th grade and their parents about the harm of alcohol. A year later the alcohol consumption among the students had decreased. The parents were less accepting of their teens consuming alcohol so the access to alcohol reduced. The environmental changes and the expectancy towards alcohol consumption helped to reducing alcohol use (Glanz et al., 2002).

Self-control regulates behaviour providing opportunities for self-monitoring (Redding, et al., 2000). The process of obtaining control, having a plan and a goal enable change for a healthier lifestyle (Bandura, 2004). Together with social support, this will help to facilitate an action plan to decline alcohol when offered and instead focus the health benefits (Eysenck, 1998). Koning et al. (2011) conducted an intervention that entailed training adolescence to develop a higher self-control to have a healthier view on alcohol consumption. The parents were educated on the negative effects of adolescent drinking. The results show that adolescent weekly alcohol consumption reduced.

The SCT has come under criticism for ignoring biological factors and heritage that may influence behaviour regardless of experience and expectations (Eysenck, 1998). It disregards genetic differences that can account for the individual differences between behaviour. Observation and modelling is a dominant factor in the SCT. Research shows that children will imitate and adult showing aggressive behaviour towards a Bobo doll (Eysenck, 1998). Yet, children will not imitate an aggressive behaviour towards another child. This showed that a child will not imitate an adult blindly. In addition, a child that is unfamiliar with the doll is more likely to imitate the aggressive behaviour (Cumberbatch, 1991; as cited in Eysenck, 1998). In this case, the novelty value of the Bobo doll is important to incorporate (Eysenck, 1998).

Conclusion.

Although the SCT have been under some criticism arguing that there is not emphasis on biological factors it has been very influential (Eysenck, 1998). According to the SCT individual health is a social responsibility. Via observing and modelling others, an individual learn what behaviour is rewarded or punished and act upon it (Eysenck, 1998). Knowledge about the health risk and potential benefits is an essential aspect towards change in health behaviour (Bandura, 2004). In addition to observing others success and highly value the outcome and reward (Eysenck, 1998). Learning through observing and obtaining cognitive and behavioural skills for coping with tempting situations are essential towards change in health behaviour (Redding, et al., 2000). An individual who wants to stop consuming alcohol but, lacks the skills to cope with stressful situations is less likely to change the behaviour in spite motivation (Redding et al., 2000). Research indicate that self-efficacy predict intentions and behaviour towards leading a healthy lifestyle (Eysenck, 1998). Personal belief in their ability to success will also predict if an individual will be successful in obtaining their goal. However, as noted earlier a person can go from low-efficacy to high-efficacy with the right treatment (Burling, Reilly, Moltzen, & Ziff, 1989).

.