Many people choose to expose themselves to potentially dangerous sounds such as loud music, either via speakers, personal audio systems, or at clubs. The Conditioning, Adaptation and Acculturation to Loud Music (CAALM) Model has proposed a theoretical basis for this behaviour. To compare the model to data, we interviewed a group of people who were either regular nightclub-goers or who controlled the sound levels in nightclubs (bar managers, musicians, DJs, and sound engineers) about loud sound. Results showed four main themes relating to the enjoyment of loud sound: arousal/excitement, facilitation of socialisation, masking of both external sound and unwanted thoughts, and an emphasis and enhancement of personal identity. Furthermore, an interesting incidental finding was that sound levels appeared to increase gradually over the course of the evening until they plateaued at approximately 97 dBA Leq around midnight. Consideration of the data generated by the analysis revealed a complex of influential factors that support people in wanting exposure to loud sound. Findings were considered in terms of the CAALM Model and could be explained in terms of its principles. From a health promotion perspective, the Social Ecological Model was applied to consider how the themes identified might influence behaviour. They were shown to influence people on multiple levels, providing a powerful system which health promotion approaches struggle to address.

Sounds at levels that can injure the ear are regarded as enjoyable by many people. In many societies, a common form of this behavior is listening to loud music, either via personal audio systems or at music venues. Drawing on theory from the literature around loud sound and emotional responses to music, and combining it with concepts of physiological sound adaptation and classical conditioning, we developed a model of the process that may underlie people's enjoyment of loud sound, particularly loud music in nightclubs. The Conditioning, Adaptation, and Acculturation to Loud Music (CAALM) model proposes that the benefits associated with loud sound, alongside other desirable aspects of nightclubs, provide the unconditioned stimuli. Over time regular clubbers become conditioned to enjoy loud sound in itself. Exposure to loud sound also causes adaptation within the auditory system, so there is both a desire for, and tolerance of, loud sound during leisure time. This sets up an expectation of loud music as a cultural norm, and staff of leisure venues, who are themselves part of that culture, set music levels to meet customer expectations; and a cycle is perpetuated. This theory may be a useful consideration for health promotion and hearing conservation interventions.