Differential prevalence of alcohol use among 2-year and 4-year college students

Alcohol and marijuana use, consequences, and perceived descriptive norms: Differences between two- and four-year college students

Objective: Among two-year college students, alcohol and marijuana use, related consequences, and risk factors for use are not well understood. We examined differences between two- and four-year students in alcohol and marijuana use, consequences, and perceived descriptive norms, and explored whether two-year status moderated associations between norms and use. Participants: Data were drawn from a cross-sectional subsample of two- and four-year students aged 18-23 (n = 517) participating in a longitudinal study on alcohol use. Results: Four-year students reported greater alcohol use and consequences than two-year students; two-year students reported greater marijuana use than four-year students. Perceived alcohol and marijuana norms were positively related with use; two-year status did not moderate these associations. Conclusions: Perceived alcohol and marijuana norms function similarly for two- and four-year students in terms of associations to actual use. Adapting normative interventions for two-year students may be an effective strategy for reducing high-risk use among this underserved population.

Feasibility and Acceptability of the Social Media-Brief Alcohol Screening and Intervention for College Students Intervention

PURPOSE

Community college (CC) students represent an at-risk population for alcohol use with limited access to campus interventions. The Brief Alcohol Screening and Intervention for College Students (BASICS) is available online, though identifying CC students at risk and connecting them to interventions remains challenging. This study tested a novel approach using social media to identify at-risk students and prompt delivery of BASICS.

METHODS

This randomized controlled trial examined the feasibility and acceptability of Social Media-BASICS. Participants were recruited from five CCs. Baseline procedures included a survey and social media friending. Social media profiles were evaluated using content analysis monthly for nine months. Intervention prompts included displayed alcohol references indicating escalation of or problematic alcohol use. Participants who displayed such content were randomized into the BASICS intervention or an active control. Measures and analyses assessed feasibility and acceptability.

RESULTS

A total of 172 CC students completed the baseline survey, mean age was 22.9 (standard deviation = 3.18) years. Most were female (81%), with many (67%) identifying as White. Among participants, 120 (70%) displayed alcohol references on social media, prompting intervention enrollment. Of randomized participants, 94 (93%) completed the preintervention survey within 28 days of the invitation. The majority of participants reported positive intervention acceptability.

DISCUSSION

This intervention combined two validated approaches: identification of problem alcohol use displays on social media, and provision of the Web-BASICS intervention. Findings demonstrate the feasibility for novel web-based interventions to reach CC populations.

Physical and mental health issues facing community college students

ObjectiveTo examine health concerns among community college (CC) students by (1) identifying and coding the self-reported health issues facing CC students and (2) examining demographic and psychosocial variables associated with health categories. Participants: 946 CC students (M_age = 26.37) recruited from January 2017 to February 2017 who completed a screening survey for a larger study. Students were asked to "List three health issues facing Community College students today." Methods: Health issues were coded into broad categories and subcategories. Results: Among the 2,601 health issues reported, one-third were medical health (36%), one-third were mental health (33%), with substance use (14%), other health (14%), and access to health care (3%) also reported. The most commonly identified health issues were "general medical issues," "stress," "depression," and "sleep." Conclusions: Programmatic efforts to support CC students and promote prevention/intervention strategies for mental health, sleep, substance use, access to health care, and general medical concerns, remain essential.

Associations between Impulsivity and Exercise Addiction, Disordered Eating, and Alcohol Use Behaviors: A Latent Profile Analysis

BackgroundDespite the known negative consequences of exercise addiction and preliminary evidence suggesting that it may co-occur with other health risk behaviors, no studies to date have examined exercise addiction among college students in conjunction with disordered eating behaviors and alcohol use. The aim of this study was to describe which college students are most at-risk for co-occurring health risk behaviors to enhance the efficiency of health risk prevention efforts. Method: Guided by multidimensional theories of impulsivity and substance use models of comorbidity, this study used latent profile analysis to examine whether separate, conceptually meaningful profiles of risk for exercise addiction, disordered eating behaviors, and alcohol use would emerge among 503 college students from a large public university. Results: The best-fitting model supported three profiles. MANOVA results revealed significant profile differences based on exercise addiction, binge eating, purging, laxative/pill/diuretic use, exercising longer than 60 minutes, negative urgency, and problematic alcohol use. Profile 3 students (n = 29), labeled the Affect Driven Health Risk-Takers, demonstrated the highest levels of impulsivity (i.e., negative urgency, lack of premeditation, lack of perseverance, and sensation seeking) and the most risk behaviors compared to the other two profiles. Profile membership was associated with distinct levels of negative urgency, exercise addiction, disordered eating behaviors, and problematic alcohol use. A small proportion of undergraduates demonstrated co-occurring exercise addiction, disordered eating behaviors, and problematic alcohol use. Profile membership also predicted the health outcomes of clinically significant exercise addiction and hazardous alcohol use. Conclusions: Findings illuminated how patterns of risk behavior engagement were associated with clinically significant exercise addiction and hazardous alcohol use and will inform prevention efforts and clinical interventions with at-risk college students.

Brief Alcohol Screening and Intervention for Community College Students (BASICCS): Feasibility and preliminary efficacy of web-conferencing BASICCS and supporting automated text messages

Objective: The Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff et al., 1999) is an evidence-based approach to reduce high-risk drinking and associated harms; however, implementation may present challenges for community colleges (CCs) that have limited budgets and mostly non-residential students. We examined feasibility, acceptability, and efficacy of BASICS for CC students (BASICCS) delivered remotely via web-conferencing with supporting automated text messages. Method: Participants included 142 CC students who reported exceeding National Institute on Alcohol Abuse and Alcoholism (NIAAA's) weekly low-risk drinking recommendations and/or heavy episodic drinking (HED). Participants were randomized to BASICCS or assessment-only control (AOC) and completed 1- and 3-month follow-up assessments. Results: Most students liked the personalized information in the program and found the web-conferencing platform useful, however intervention completion rate was 56%. Significant differences were found between BASICCS and AOC. At 1-month, individuals in BASICCS had 33% fewer alcohol consequences than those in AOC. At 3-month follow-up, individuals in BASICCS had lower estimated peak blood alcohol concentration, 29% fewer drinks per week, 62% fewer episodes of HED, and 24% fewer consequences than those in AOC. Conclusions: BASICCS showed evidence of being acceptable and the technology proved feasible, although the intervention completion rate in the non-treatment-seeking volunteer sample was modest. Preliminary evidence does suggest BASICCS shows promise in reducing alcohol use and consequences. Technology-based platforms could be a viable prevention solution for CC students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cohort and age trends in age 35-45 prevalence of alcohol use disorder symptomology, by severity, sex, race, and education

AIMS

To present national trends by age and cohort among middle-aged adults in the prevalence of AUD symptomology, by severity, sex, race, and education.

DESIGN

National, multi-cohort longitudinal probability samples of US adults, with data collected at ages 35, 40, and 45 among 14 cohorts who reached age 45 between 2003 and 2016.

SETTING

Data were collected via self-administered questionnaires to adults in the United States.

PARTICIPANTS

The sample consisted of 20,634 individuals.

MEASUREMENTS

5-year prevalence of symptoms consistent with a DSM-5 AUD.

FINDINGS

Between ages 35-45 prevalence of any AUD symptoms decreased 19 %; decreases were most evident between ages 35-40. From 2003 to 2016, AUD symptoms were steady across cohort. However, because the pace of decrease across ages 35-45 slowed across cohort, cohort differences emerged at specific ages: age 35 prevalence decreased 18 % across cohort, but age 45 prevalence was equivalent across cohort. Age and cohort effects, and their interaction, did not vary by AUD severity level. Declines in AUD symptoms across age were 17 % slower for women, and declines in AUD symptoms across age and cohort were 11 % and 29 % slower, respectively, for those with a college degree. The protection afforded by a college degree was reversed among mild AUD and most pronounced for severe AUD.

CONCLUSIONS

AUDs may be more plastic and responsive to intervention during early mid-life than later. Despite progress in reducing the burden of AUD in the US population among younger middle-aged adults, an increased focus remains necessary as they continue to age.

Drinking Motives and Drinking Consequences across Days: Differences and Similarities between Moderate, Binge, and High-Intensity Drinking

BACKGROUND

The current study examined the extent to which within-person variation in drinking motives differentiates moderate, binge, and high-intensity drinking; and independent associations of motives and drinking intensity with alcohol use consequences in a sample of young adult drinkers from across the United States.

METHODS

Participants were past 30-day drinkers in the U.S. nationally representative Monitoring the Future 12th grade sample in 2018, who also reported alcohol use during a 14-day data collection burst 1 year later (N = 484 people, mean age 19.3 [SD 0.40], 43% female; N = 1042 drinking days) as part of the Young Adult Daily Life Study in 2019. Weighted multilevel modeling estimated within- and between-person associations of drinking motives, drinking intensity (i.e., moderate [women 1-3, men 1-4 drinks], binge [women 4-7, men 5-9 drinks], and high-intensity drinking [women 8+, men 10+ drinks]), and number of positive and negative alcohol consequences.

RESULTS

On days participants reported greater enhancement and social motives, they were more likely to engage in high-intensity (vs. binge) drinking and binge (vs. moderate) drinking and experience more positive alcohol consequences. On days participants reported greater enhancement and coping motives, they experienced more negative alcohol consequences. Binge (vs. moderate) drinking on a given day was associated with more positive and negative alcohol consequences; high-intensity (vs. binge) drinking on a given day was associated with more negative alcohol consequences that day. Moderation analyses indicated that social motives were associated with high-intensity (vs. binge) drinking only among college students.

CONCLUSIONS

Stronger drinking motives on a given day were associated with drinking intensity (enhancement and social motives) and negative consequences (enhancement and coping). High-intensity (vs. binge or moderate) drinking was associated with more negative consequences but not more positive consequences. These results underscore that high-intensity drinking and consequences vary across days and time-varying, occasion-specific risks such as current motivational context are appropriate targets for intervention.

Sexual Assault, Sexual Orientation, and Reporting Among College Students

Research has demonstrated significantly higher rates of sexual assault victimization among lesbian, gay, bisexual and queer (LGBQ) students than heterosexual students, and the overwhelming majority of assaults are not reported to any official system. Given the potential for support services to provide valuable assistance and promote well-being after an assault, the present study explores whether LGBQ students report assaults at similar rates to heterosexual students. As part of the 2015 College Student Health Survey, 10,646 male and female college students at 2- and 4-year colleges in Minnesota provided data regarding sexual assault victimization; reporting to a health care provider, campus authority, police, or social contact; and sexual orientation (two items, including write-in). Chi-square tests were used to detect associations between sexual assault victimization and five sexual orientation groups; and between sexual orientation and assault reporting (for 523 assault incidents). Almost 6% of students reported that they had experienced sexual assault in the previous 12 months. Significant differences in assault experience were seen by sexual orientation groups, for both males and females. For example, rates of sexual assault were 2.5 to over 5 times higher among bisexual and queer/pansexual/other females than among heterosexual females. Reporting of sexual assault to health care providers, campus authorities or police was rare for both heterosexual and sexual minority students, and there were no significant differences in reporting across sexual orientation. LGBQ students and heterosexual students appear to be similarly comfortable accessing health care providers, police, and campus resources, suggesting that these services are not overtly biased or unwelcoming to sexual minorities. However, rates of sexual assault were considerably higher among sexual minority groups, suggesting a need for primary prevention that is appropriate and sensitive to the experiences of LGBQ students.

Sociodemographic and health disparities among students screening positive for food insecurity: Findings from a large college health surveillance system

Food insecurity among college students has begun to be recognized as a pressing social issue. However, much of the research in this area to date is limited by factors like small sample sizes and convenience sampling. The objective of this study was to assess sociodemographic and health disparities among two- and four-year post-secondary students screening positive for food insecurity, using one of the largest relevant health surveillance databases available. This study included analyses of pooled annual data (2015-2018; n = 13,720) from students participating in state-based surveillance of 27 two- and four-year Minnesota post-secondary institutions. Food security was determined using a validated two-item screener. Disparities were examined across numerous factors including: sociodemographic, economic, academic, institutional, nutrition and weight-related health risk and resiliency. In total, 24% of students experienced food insecurity. Findings highlighted stark disparities, with notably high positive screening rates of food insecurity among non-Hispanic Black (43%), transgender/non-binary (42%) and first-generation (33%) students. Food insecurity was significantly associated with nearly every adverse health factor examined, despite controlling for demographics (p < 0.0001). Overall, these findings represent one of the largest peer-reviewed studies of college food insecurity to date and underscore robust differences between who experiences food insecurity and who does not. They also highlight troubling health risks that accompany food insecurity. Importantly, the COVID-19 pandemic has worsened these realities. To inform prevention efforts, additional research is urgently needed, including cohort studies, controlled trials, and quasi-experimental research based on rigorous evaluation of policy initiatives now being considered at institutional, state and federal levels.

Exposure to tobacco marketing in bars predicts subsequent use of multiple tobacco products among non-tobacco-using college students

BACKGROUND

Due to other marketing restrictions, one venue where tobacco companies concentrate their marketing efforts to reach young adults is bars/nightclubs.

OBJECTIVE

This study examined the relationship between exposure to tobacco marketing in bars/nightclubs and number of alternative tobacco/nicotine products used 6 months later among college students.

METHODS

Participants were 1,406 students aged 18-29 years old who reported going to bars or nightclubs at least rarely (M age=21.95; 67% female; 46% non-Hispanic white). Students completed an online survey in fall 2014/spring 2015 (wave 1) and again 6 months later (wave 2). Multilevel Poisson regression models were used to assess the relationship between exposure to three types of marketing at bars/nightclubs at wave 1 (tobacco/nicotine product advertisements; free samples; industry representatives) and number of tobacco products used (range=0-5) at wave 2, controlling for school type (2 year vs 4 year), age, sex, race/ethnicity and frequency of bar visits. An interaction between the number of wave 1 products and each marketing variable was tested.

RESULTS

Greater exposure to free samples and tobacco industry representatives at bars/nightclubs predicted a greater number of products used 6 months later, but only among wave 1 non-tobacco users and not among tobacco users. Exposure to advertisements at bars/nightclubs did not predict the number of products used 6 months later.

CONCLUSION

Tobacco companies claim that marketing is targeted to those who already use the product, not to non-users. However, the current study indicates tobacco marketing in bars and nightclubs may encourage use among non-users and has no influence on current users.

Close Friends' Drinking and Personal Income as Mediators of Extreme Drinking: A Prospective Investigation

OBJECTIVE

This study examined longitudinal associations between college attendance, residence on- or off-campus, and work status during the first 2 years after high school with extreme binge drinking at 4 years after high school and tested peer drinking and personal income at 3 years after high school as mediators.

METHOD

Data were drawn from Waves 4-7 of the NEXT Generation Health Study (n = 2,081). Multinomial logistic regressions and mediation analyses were conducted. Extreme binge drinking was measured using the largest number of drinks on a single day in the past year.

RESULTS

Univariate analyses indicated that attending university, living on campus, and working more than 30 hours at any point during the first 2 years after high school were associated with increased risk of drinking two to three times above the binge drinking threshold (relative risk ratios [RRR] ranged from 1.79 to 5.70). In multivariate analyses, dropping out of university was associated with drinking two times above the binge drinking threshold (RRR = 4.88), whereas living on campus (RRR = 4.54) and working more than 30 hours (RRR = 5.26) were associated with increased risk of drinking three times above the binge drinking threshold. Close friends' drinking and personal income were significant mediators.

CONCLUSIONS

Living on campus and working more than 30 hours per week during the first 2 years after high school increased risk for drinking three times above the binge drinking threshold at 4 years after high school.

Negative alcohol-related consequences experienced by young adults in the past 12 months: Differences by college attendance, living situation, binge drinking, and sex

PURPOSE

This study estimated the prevalence of negative consequences associated with alcohol use in a national sample of young adults one or two years after graduating from high school, focusing on differences by college attendance, living situation, binge drinking, and sex.

METHODS

A subsample (N = 1068) of U.S. nationally representative Monitoring the Future study 12th grade students from 2006 to 2016 cohorts was followed-up at modal age 19 or 20 (in 2008-2017) and asked about negative consequences related to their own alcohol use during the past 12 months. Differences in prevalence were estimated and multivariable models examined associations with college attendance, living situation, binge drinking, and sex.

RESULTS

Half of surveyed U.S. 19/20 year-old alcohol users (a third of non-binge drinkers and almost three-quarters of binge drinkers) experienced negative consequences in the past year. The likelihood of experiencing several consequence types was significantly associated with college attendance prior to controlling for living situation. In multivariable models controlling for living situation, unsafe driving due to drinking remained more likely for students attending 2-year colleges or vocational/technical schools than for 4-year college students or non-attenders. In general, negative consequence risk was elevated among young adults not living with parents (vs. those living with parents) and women (vs. men).

CONCLUSION

Negative consequences from alcohol use are prevalent among young adults and differ by college attendance, living situation, binge drinking, and sex. Students at 2-year/vocational/technical schools are at particular risk for unsafe driving, warranting specific research attention and targeted intervention.

Perceived descriptive norms for alcohol use among tribal college students: Relation to self-reported alcohol use, consequences, and risk for alcohol use disorder

This research addressed gaps in the literature by testing relationships between perceived descriptive alcohol use norms and individual's own alcohol use and consequences among tribal college and university (TCU) students. Survey data were collected from 3239 tribal college students in 22 TCUs across the United States in 2015 and 2016, of whom 3174 provided usable data on the variables of interest for the current manuscript. Results indicated students misperceived the descriptive norms for alcohol use at their TCU, on average estimating students at their college drank more frequently, more per occasion, and more total drinks per week relative to the observed averages on these outcomes. Participants' own drinking was significantly related to their perceived norms, with higher perceived norms related to more drinking. In addition, higher perceived norms were associated with greater alcohol-related negative consequences and lower likelihood of being a non-drinker. These findings extend research with students at majority-serving colleges and universities, indicating normative misperceptions exist and have similar relationships to alcohol use and consequences among TCU students nationwide. These findings support adaptation of normative feedback interventions for use with TCU students to emphasize healthy alcohol norms and correct misperceptions that support the stereotype that all students drink to excess.

Cumulative Risk of Substance Use in Community College Students

BACKGROUND AND OBJECTIVES

Substance use in community college students has been explored in only a handful of studies. Differences in population characteristics and substance use between 2- and 4-year students suggest that different factors may promote and thwart this behavior. Cumulative risk is a parsimonious methodology that provides better model stability and more statistical power, yet it has only been recently used in substance use research. The aim of this study is to investigate multiple aspects of substance use risk in a population in need of substance use prevention and intervention services.

METHODS

We conducted a cross-sectional study of community college students (N = 288; 75% female) examining the relative contributions of different domains of cumulative risk (eg, life stressors, academic stressors, and mental health diagnoses) to develop different profiles of risk across substance use classes (ie, alcohol, cigarette, marijuana, and hard drug use).

RESULTS

Cumulative risk analyses indicated that alcohol and tobacco use were associated with the domains of life stressors and peer/family substance use, marijuana use with peer/family substance use and stressful childhood experiences, and hard drug use with peer/family substance use, lack of social support, low access to care, and stressful childhood experiences.

DISCUSSION AND CONCLUSIONS

Different strategies for prevention and intervention may be necessary to effectively address different forms of substance use in this population.

SCIENTIFIC SIGNIFICANCE

The risk domain profiles related to specific drugs may lead to targeted interventions to reduce substance use in community college students. (Am J Addict 2020;29:97-104).

College attendance type and subsequent alcohol and marijuana use in the U.S

BACKGROUND

College attendance is a risk factor for frequent and heavy drinking and marijuana initiation but less is known about the extent to which risk varies by type of college attendance and across age.

METHODS

Using panel data of young adults who were high school seniors in 1990-1998 from the Monitoring the Future study (n = 13,123), we examined the associations between college attendance at age 19/20 (4-year college full-time, other college, and non-attendance) and subsequent alcohol and marijuana use at age 21/22, 25/26, 29/30 and 35. Inverse propensity score weighting was used to balance the three college groups on pre-existing differences when examining associations with substance use outcomes.

RESULTS

Compared to non-attendance, attending a 4-year college full-time was associated with significantly greater odds of binge drinking at age 21/22 (aOR = 1.20) and 25/26 (aOR = 1.12) and lower odds of alcohol abstinence at age 35 (aOR = 0.51). Similarly, other college attendance was associated with greater odds of binge drinking at age 21/22 (aOR = 1.08) and 25/26 (aOR = 1.04) and lower odds of abstinence at age 35 (aOR = 0.70). Four-year college full-time attendance was associated with greater odds of marijuana use at age 21/22 (aOR = 1.07) and 25/26 (aOR = 1.02) but lower odds at age 29/30 (aOR = 0.99). Other college attendance was associated with lower odds of marijuana use at age 25/26 (aOR = 0.98) and 29/30 (aOR = 0.97). Marijuana use at age 35 did not differ by college attendance.

CONCLUSIONS

College attendance may confer elevated risk of substance use post-college. The magnitude and duration of risk vary by type of college attendance and substance.

Alcohol Use and Intimate Partner Violence Among Community College Women: An Exploration of Protective Factors

Little is known regarding the association between alcohol use and violence among community college women. Accordingly, this study investigated daily-level associations between alcohol use and intimate partner victimization (IPV) in a sample of young women (ages 18-24) in a community college setting, and the potentially protective role of education aspirations and living with family. Using a calendar-based assessment, women enrolled in a large community college (N = 212) completed past-month surveys of IPV and alcohol use. Unadjusted Generalized Estimating Equations showed nonsignificant positive associations between alcohol consumption (any alcohol use and number of drinks) and IPV at the daily level. Adjusted models showed a slight (but nonsignificant) increase in the odds of experiencing IPV on a drinking day. Those reporting a family income above $20,000 were at increased risk of experiencing violence. Living with family and wanting to attain a master's or doctoral degree reduced the risk of experiencing IPV on drinking days. Although the literature suggests that drinking among 4-year college women elevates the odds of experiencing IPV, our findings suggest the importance of examining contextual variables when understanding risk among community college women. Particularly, the role of family and educational aspirations may serve as protective factors in the association between alcohol use and IPV on a daily basis. As this is the first day-level study of IPV and alcohol use among community college women, further research is warranted to better explicate these findings.

Flavored Cigars Appeal to Younger, Female, and Racial/Ethnic Minority College Students

Introduction

This study examined the association of sociodemographic characteristics, tobacco and substance use behaviors, and reasons to use cigars in young adults' flavored and non-flavored cigar use.

Methods

Participants were 523, 18- to 29- year-old young adult college students (60.4% male; 40.9% non-Hispanic white) who reported current (past 30-day) cigar use.

Results

Almost 75% of the sample regularly chose flavored cigar products. Multilevel logistic regression analyses indicated that younger, female, and racial/ethnic minority cigar users had significantly greater odds of using flavored cigars than their counterparts. Current marijuana smokers, ever-blunt smokers, and students who reported using cigars because they were affordable and/or available in flavors they liked had a greater odds of flavored cigar use compared to their counterparts. Moreover, among dual users of cigars and cigarettes, those who cited using cigars because they were cheaper than cigarettes and because cigars felt like smoking regular cigarettes had greater odds of using flavored cigars compared to their peers. Number of days cigars were smoked and current use of other tobacco products were not associated with flavored cigar use.

Conclusions

Appealing attributes of flavored cigars have the potential to contribute to the tobacco use and subsequent nicotine addiction of younger, female, and racial/ethnic minority young adults. The wide variety of cigar flavors, their attractive price, and similarity to cigarette smoking underscore the need for additional research that links these unique traits to sustained tobacco use, and underscore the need for regulation of flavored products.

Implications

This study extends the current literature by finding that younger, female, and racial/ethnic minorities have greater odds of flavored cigar use than their peers. Flavored cigars have characteristics that appeal to members of these populations, which can contribute to their long-term use and potential for addiction.

Patterns of alcohol use and marijuana use among students at 2- and 4-year institutions

Objective: The objective of this study was to understand substance use patterns of alcohol, marijuana, and simultaneous alcohol and marijuana (SAM) use among 2- and 4-year college students. Participants: Participants were 526 young adults aged 18-23 (n = 355 4-year students; n = 171 2-year students) recruited from February 2015 to January 2016 who were participating in a larger longitudinal study. Methods: Latent class analysis (LCA) was used to identify past-month classes of alcohol, marijuana, and SAM use. Results: Among both 2- and 4-year students, a four-class solution yielded the best-fitting model, with 2-year classes tending to include greater marijuana use and less alcohol use and 4-year classes tending to include heavy alcohol use. Demographic characteristics were largely similar across classes. Conclusions: Classes of alcohol, marijuana, and SAM use differed by education status. Screening and prevention efforts for 4-year students may need to be tailored for the needs of 2-year students.

Identifying Barriers to Mental Health Service Utilization Among Heavy Drinking Community College Students

There are limited findings on mental health prevalence and service utilization rates among community college (CC) students. Utilizing a heavy drinking CC sample, the current study examined: 1) prevalence of mental health symptoms, 2) mental health service utilization and perceived unmet service need, and 3) barriers to service utilization. Participants were 142 CC students who were heavy alcohol users (70% female; 59% White) from three public CCs in the Pacific Northwest who were participating in a larger study designed to adapt a brief intervention for high-risk alcohol use. Findings of the current study revealed that 32% of CC students had a positive screen for depression; 25% had a positive screen for anxiety; a total of 28% received mental health services in the past 12 months; a total of 41% reported a perceived unmet need for mental health services at some point in the past 12 months (i.e., needing mental health services but not receiving it). Students with mental health symptoms reported more barriers to receiving services, and were more likely to not receive services due to cost, compared to students without mental health symptoms. There were differences in type of barrier as a function of alcohol use severity, although there was no difference in number of barriers. Campuses may benefit from understanding mental health service utilization barriers their students report and to effectively advertise the services offered. Training of student services personnel staff and faculty in screening for mental health or substance use may be a worthwhile and cost-effective endeavor.

Longitudinal predictors of cigarette use among students from 24 Texas colleges

Objective: The purpose of this study is to examine differences between current and non-current cigarette users, focusing on sociodemographic factors, non-cigarette tobacco product use, parental and friend use, and alcohol and marijuana use; and to identify predictors of cigarette use sixmonths later. Participants: Participants included young adults (n = 4,296) from 24 Texas colleges, participating in a young adult cohort study, beginning in fall 2014. Methods: Mixed effects logistic regressions were conducted accounting for school-level variability. Results: Cigarette users were older, more likely to report use of non-cigarette tobacco products and peer use of cigarettes than non-current users. Wave 1 cigarette and non-cigarette tobacco product use, marijuana use and binge drinking, and peer use all uniquely predicted cigarette use at wave 2. Conclusions: Colleges need prevention programs targeting multiple tobacco products, because non-cigarette tobacco use and other risky behaviors appear to be independent risk factors for cigarette use in young adults.

Developing Text Messages to Reduce Community College Student Alcohol Use

Objectives The aim of this study is to evaluate how community college students with hazardous drinking perceived the usefulness of alcohol protective behavioral strategy text messages (TM-PBS). Methods Community college students with past hazardous single occasion or weekly drinking (N = 48; 60% female) were randomized to receive 2 TM-PBS on 3 typical drinking days per week for 2 weeks selected by: (1) research investigators (ie, based on clinical and theoretical application); (2) participants (ie, messages highly rated at baseline by the participants); or (3) a random process. Prior to 2 typical drinking days per week, immediately after receiving TMs, we asked: "How useful do you think this strategy will be for you when you drink? Text a number from 1 (not useful) to 5 (very useful)." Results Response rates for the 12 messages ranged from 72.9% to 87.5%, with no differences in response rates across selection categories (ie, investigator, participant, random). Investigator-selected messages were rated as less useful than messages that were self-selected by participants or messages that were selected at random. Conclusions TM-PBS chosen a priori by students were perceived as more useful than TM-PBS chosen by investigators, supporting this form of tailoring in alcohol interventions to optimize usefulness.

Transitions into young adulthood: Extent to which alcohol use, perceived drinking norms, and consequences vary by education and work statuses among 18-20year olds

INTRODUCTION

With many young adults pursuing post-secondary education and many working, understanding the importance of education and work roles on alcohol use are of developmental and clinical importance. Utilizing a sample of 18-20year-olds transitioning from adolescence to young adulthood, the current study examined how social role statuses in education (i.e., not in school, 2-year students, 4-year students) and work status (i.e., unemployed, employed part-time, employed full-time) were associated with alcohol use, alcohol-related consequences, and perceived drinking norms.

METHOD

Participants were 18-20year old young adults (54% female) participating in a one-time online survey about alcohol use and sexual behavior. Regression models were conducted to examine associations between school status and work status with alcohol related outcomes.

RESULTS

Individuals who were unemployed had a significantly lower likelihood of any heavy episodic drinking (HED) in the past month, consumed fewer drinks per week, and experienced fewer alcohol-related consequences compared to individuals who worked full-time. Individuals who worked part-time consumed fewer drinks per week and had lower perceived drinking norms compared to individuals who worked full-time. No significant associations were found for alcohol use and consequences by education status.

DISCUSSION

Working full-time is a risk factor for HED, greater weekly drinking and negative alcohol-related consequences when compared to young adults who are unemployed, and to a lesser extent with young adults working part-time. Workplace interventions may be one approach to reach heavy drinking young adults.

Exclusive e-cigarette use predicts cigarette initiation among college students

INTRODUCTION

An increasing body of research indicates that use of electronic nicotine delivery systems (ENDS) predicts cigarette initiation. However, no studies examine if risk for cigarette initiation varies for exclusive ENDS users versus users of ENDS and other tobacco products. This study examined if: a) cigarette-naïve young adults (i.e., never cigarette users) who ever used ENDS had a greater odds of initiating cigarettes than non-ENDS users over a 1.5year period and b) the odds of cigarette initiation was consistent across exclusive ENDS users and users of ENDS and at least one tobacco product.

METHODS

Participants were 2558 cigarette-naïve 18-25year old (M=19.71; SD=1.61) students from 24 Texas colleges who participated in a four-wave study, with six months between each wave.

RESULTS

Overall, 11% of students reported cigarette initiation by wave 4. Of those, 20.1% were wave 1 ENDS users and 8.4% were non-ENDS users. Multivariable, multilevel discrete-time hazard models indicated that wave 1 ENDS use predicted subsequent cigarette initiation, over and above the significant effects of cigarette use susceptibility, family-of-origin tobacco use, friend cigarette use, and other tobacco use. Additional findings indicated that exclusive ENDS users had a greater odds than non-users of subsequent cigarette initiation. Among users of alternative tobacco products, ENDS users did not have a greater odds of initiation than non-ENDS users.

CONCLUSION

Findings extend existing research by showing that ENDS use by young adults is a specific risk factor for later cigarette initiation and not an extension of a constellation of existing tobacco use behaviors.

Alcohol Expectancy, Drinking Behavior, and Sexual Victimization Among Female and Male College Students

College students have high rates of heavy drinking, and this dangerous behavior is strongly linked to sexual victimization. Although research has examined risk factors for sexual assault, few studies have simultaneously studied the various pathways through which risks may affect sexual assault and how these pathways may be uniquely different among females and males. As such, the current study uses path analyses to examine whether alcohol expectancies mediate the relationship between social factors (e.g., hooking up, amount friends drink) and drinking behavior and experiencing sexual victimization, and whether drinking behavior mediates the relationship between alcohol expectancies and sexual victimization among a college sample of 704 males and females from a large Midwestern university. For both females and males, sexual victimization was positively associated with child sexual abuse, hooking up more often, and heavier drinking, whereas greater alcohol expectancies were associated with sexual victimization only for females. Several mediating pathways were found for both females and males. Gender comparisons revealed that some of the pathways to sexual victimization such as hooking up, amount friends drink, and housing type operated differently for females and males.

Up for Grabs? Sexual Objectification as a Mediator Between Women's Alcohol Use and Sexual Victimization

Sexual objectification, the tendency to reduce women to their bodies, body parts, or sexual functions for use by others, has been theorized to set the stage for more severe acts of violence but has been largely absent from the existing sexual victimization literature. The purpose of this study was to explore the role of sexual objectification in mediating the well-established link between women's alcohol use and sexual victimization. A large sample of undergraduate women ( N = 673) reported their alcohol use (frequency and quantity), experiences of sexual objectification (body evaluation and unwanted explicit sexual advances), and sexual victimization. Results indicated positive bivariate correlations among all study variables. Path analyses showed that mild forms of sexual objectification (body evaluation) mediated the link between the frequency of alcohol use and more extreme forms of sexual objectification (unwanted advances). Furthermore, the combined effect of sexual objectification (body evaluation and unwanted advances) mediated the link between alcohol use (frequency and quantity) and sexual victimization. The current findings are among the first to evaluate sexual objectification as a mechanism in the link between alcohol use and sexual victimization. Results suggest that efforts to prevent alcohol-related sexual violence may benefit from addressing sexual objectification.

College students' perceptions of risk and addictiveness of e-cigarettes and cigarettes

BACKGROUND

As conventional cigarette use is declining, electronic cigarette ("e-cigarette") use is rising and is especially high among college students. Few studies examine dual use of e-cigarettes and cigarettes among this population. This study explores the relationship between dual and exclusive e-cigarette / cigarette use and perceptions of harm and addictiveness of both products.

METHODS

This is a cross-sectional analysis of data from students attending 24 colleges in Texas (n=5,482). Multinomial logistic regression was employed to test the association between current e-cigarette / cigarette use and perceived harm and addictiveness of both products. Three tobacco groups were included: cigarette only users, e-cigarette only users, and dual users.

RESULTS

Dual users reported lower perceived harm of e-cigarettes most consistently (p<0.001, all comparisons). Perceived harm of cigarettes was significantly lower among cigarette only and dual users only, compared to non-users (p<0.001, all comparisons). Compared to non-users, all three groups reported significantly lower perceived addictiveness of e-cigarettes (p<0.001, all comparisons). The same finding was observed for perceived addictiveness of cigarettes, though findings were less consistent for the e-cigarette only group (p<0.02, all comparisons except one).

CONCLUSION

Findings demonstrate that among college students, perceptions of harm and addictiveness of e-cigarettes are lower than those for conventional cigarettes. For both products, perceptions of harm and addictiveness were lower among exclusive and dual users, compared to non-users.

College students' perceptions and knowledge of hookah use

PURPOSE

Hookah is an increasingly popular tobacco product among college students. The purpose of this study was to determine if college students are aware of tobacco and nicotine content in hookah, and examine associations between college students' knowledge and perceptions of hookah and their past 30-day hookah use.

METHODS

Participants were 5451 young adults attending one of 24 2- and 4-year colleges. Analyses examined if hookah knowledge was uniquely associated with current hookah use, over and above perceptions of harm and addictiveness, number of other tobacco products currently used, and socio-demographic factors. Analyses were first conducted for the entire sample and then only for current hookah users.

RESULTS

26.9% of all students believed hookah did not contain tobacco and 38% believed that hookah did not contain nicotine. Students who believed that hookah contained tobacco were at increased odds of hookah use, and those with increased perceptions of harm were at decreased odds of hookah use. However, hookah knowledge was not associated with hookah users' intensity of use. Moreover, although increased perceptions of harm were associated with lower intensity of use among current users, increased perceptions of addictiveness were associated with higher intensity of use.

CONCLUSIONS

This study shows gaps in knowledge of hookah contents, and adds to the body of literature, which provides evidence for mandating warning labels as well as tobacco interventions for college students.

College Status, Perceived Drinking Norms, and Alcohol Use among Sexual Minority Women

Lesbian, gay, and bisexual young adults are at elevated risk for drinking compared to heterosexual young adults, and this discrepancy is particularly striking for sexual minority women (SMW). Perceived social norms are strong predictors of young adult alcohol use, especially among college students. The college environment is often one where increases in alcohol use are seen, but the impact of college status on SMW's drinking has been understudied. The present study explored patterns of alcohol use and consequences among SMW and the extent to which social norms relate to use and consequences. Participants were recruited via social networking sites for a larger national study on SMW's health behaviors. Present analyses focused on 875 SMW between 18 and 25 who were categorized as either a 2-year college student (n = 196), 4-year college student (n = 418), or non-student (n = 261). Several differences emerged between college and non-college SMW, with non-college women reporting higher alcohol use and social norms compared to 4-year college women. In terms of alcohol-related consequences, students in both 2-year and 4-year colleges reported a higher likelihood of any consequences. There was some evidence that perceived norms partially explained differences in typical drinking among the college status groups. The present findings suggest that college may play a protective role against heavy drinking for this population of young women, however, the results are not straightforward and additional research is warranted.

Tobacco Use and Substance Abuse in Students of Karaj Universities

BACKGROUND

It is clear that tobacco smoking and substance abuse have negative consequences on adolescent and youth's health. Tobacco smoking especially hookah smoking has increased worldwide especially among university students. This study aimed to determine the prevalence of risk-taking behaviors such as cigarette smoking, hookah smoking, alcohol use, and drug abuse and its predictors in students of Karaj universities.

METHODS

This cross-sectional study took place in Karaj in January and February 2014. The randomly selected sample consisted of 1959 college students. A self-administered questionnaire was used to measure risk-taking behaviors as well as demographic and related risk factors. Logistic regression model was performed in data analysis.

RESULTS

The prevalence of cigarette smoking was 9.3%. The prevalence of hookah smoking was 9.3%. 7% of students used illegal drugs and 9.5% of students used alcohol at least once in last 30 days. After adjustment for other factors, being male, living without parents, having smoker friends, and presence any smoker in the family were factors associated with students' risk-taking behaviors. The results showed the co-occurrence of risk-taking behaviors.

CONCLUSIONS

The prevalence of tobacco smoking and substance abuse, particular in males, are high. It seems that planning preventive interventions for this part of the population are necessary. This study emphasized the co-occurrence of risky behaviors, so, it is better high-risk behaviors simultaneously targeted at reducing or preventing interventions.

College Students' Polytobacco Use, Cigarette Cessation, and Dependence

OBJECTIVES

We examined patterns of tobacco and electronic cigarette (e-cigarette) use among college students. Differences in sociodemographic characteristics between non-users of these products and 4 mutually exclusive groups of tobacco/e-cigarette users were assessed. Differences in cigarette cessation attempts and dependence between exclusive cigarette smokers and users of cigarettes and at least one alternative tobacco product also were examined.

METHODS

Participants were 5468 18-29 year-old students from 24 colleges in Texas who completed an online survey.

RESULTS

Multiple-product use was more prevalent than single-product use. All 4 current tobacco/e-cigarette-user groups were more likely than non-users to be men and older. College students who were younger when they smoked their first cigarette, and those reporting ever needing a cigarette, were more likely to be multiple-product users than cigarette-only users. There were no group differences in cigarette cessation attempts or any other variables.

CONCLUSIONS

Using multiple products is associated with some indicators of dependence, but does not seem to aid or deter college students' smoking cessation attempts. Longitudinal research is needed given that transitions in tobacco/e-cigarette use continue throughout young adulthood.

Substance Use Disorder in Early Midlife: A National Prospective Study on Health and Well-Being Correlates and Long-Term Predictors

This study used national multicohort panel data from the Monitoring the Future study (N = 25,536 from senior year classes 1977–1997 followed up to the age of 35 years in 1994–2014) to examine how early midlife (age 35 years) alcohol use disorder (AUD) and cannabis use disorder (CUD) are associated with adolescent and adult sociodemographics and health and well-being risk factors. Survey items adapted from DSM-5 diagnostic criteria were used to identify individuals who (a) showed symptoms consistent with criteria for AUD or CUD at age 35 years, (b) used the substance without qualifying for a disorder (nondisordered users), and (c) abstained from using alcohol or marijuana during the past five years. At age 35 years, the estimated prevalence of past five-year AUD was 28.0%, and that of CUD was 6.1%. Multinomial logistic regressions were used to identify variations in the relative risk of disorder symptoms as a function of sociodemographic characteristics, age 18 educational and social indices and substance use, and age 35 health and satisfaction indices and substance use. In the full models, age 18 binge drinking and marijuana use were found to be among the strongest predictors of age 35 AUD and CUD, respectively. Among age 35 health and well-being indicators, lower overall health, more frequent cognitive difficulties, and lower satisfaction with spouse/partner were consistently associated with greater risks of AUD and CUD. Some evidence was found for a J-shaped association between age 35 AUD or CUD status and health and well-being indices, such that nondisordered users were sometimes better off than both abstainers and those experiencing disorder. Finally, nondisordered cannabis use, but not CUD, was found to be more common in more recent cohorts. Implications are discussed regarding the importance of placing early midlife substance use disorder within the context of both adolescent substance use and adult health and well-being.

Are drinking motives associated with sexual "hookups" among college student drinkers?

OBJECTIVE

This study examined associations between drinking motivation, alcohol use, and sexual hookups among college students.

PARTICIPANTS

Participants (n = 755 Midwest college student drinkers; 61% female) ranged in age from 18 to 24.

METHODS

Participants completed online measures of alcohol involvement (use and motives) and sexual activity.

RESULTS

Alcohol use was positively linked to sexual hookups. Social and enhancement motives were positively and indirectly associated with sexual hookups via alcohol use. Drinking to cope had a direct association with sexual hookups. Social drinking was more strongly associated with hookups in men than in women, but both groups exhibited a positive association.

CONCLUSIONS

This study is the first to highlight the relationships between distinct drinking motives and sexual risk behavior. The results indicate that specific motives may increase risk of sexual hookups both indirectly via alcohol use, as well as directly, at least among those that drink to cope with negative mood.

Drinking behavior and drinking refusal self-efficacy in Korean college students

The prevalence of drinking behavior and sex differences were examined. A possible relationship between drinking behavior and drinking refusal self-efficacy (DRSE) also was investigated among a convenience sample of 582 Korean college students (309 men, 273 women). A drinking habit scale (from AUDIT-K) and drinking refusal self-efficacy questionnaire (DRSEQ-R) were administered. Results indicated 74.4% of the students drank alcohol and 80.1% of the students were regular drinkers (> 2 to 4 times per month). There were significant differences in drinking behavior by sex and in the DRSE constructs for current drinking statuses. Drinking behavior was significantly associated with sex and DRSE. The present study offers more information about practical interventions aimed at reasonably controlling the drinking behavior of Korean college students in a university setting. The findings may provide better understanding of Korean students' drinking behavior.

Energy drink consumption is associated with unhealthy dietary behaviours among college youth

AIM

Energy drink consumption has been associated with a variety of health risk behaviours, yet little research has explored the relationship between energy drinks and dietary behaviours of emerging adults. Therefore, the purpose of this study was to explore the relationship between energy drink consumption and dietary behaviours among energy drink users and non-users within a sample of college youth.

METHODS

College freshmen (n = 585, m age = 18.7 years; 47% non-Hispanic White, 20.9% Hispanic, 25.5% Asian, 2.7% non-Hispanic Black and 4.4% other; 56% female), at a large, southwest university self-reported their energy drink consumption in the past week and a variety of dietary behaviours, including past week soda, diet soda, pre-packaged salty snacks, pre-packaged sweet snacks, fast food, restaurant food, frozen food, fruits, vegetables, milk and breakfast consumption. Linear regression analyses were run to determine associations between energy drink consumption and dietary behaviour among users and non-users of energy drinks. Analyses controlled for gender, race/ethnicity and body mass index (BMI).

RESULTS

Overall, 17.5% of students had consumed energy drinks in the past week. Energy drink users were more likely to be male, White and have a greater BMI. Students also reported low past week intake of fruits, vegetables, milk and breakfast. Past week energy drink consumption was associated with increased soda and frozen meal consumption.

CONCLUSION

Given a rapidly expanding energy drink market, future dietary interventions among college youth may want to consider the implications of energy drinks, as results of this study suggest consumption of these beverages is associated with unhealthy dietary behaviours and a greater BMI.

Explaining alcohol use and suicide risk: a moderated mediation model involving insomnia symptoms and gender

STUDY OBJECTIVES

The purpose of the study was to examine whether insomnia symptoms and nightmares mediated the relation between alcohol use and suicide risk. Further, we examined whether this mediation was moderated by gender.

DESIGN

The study consisted of questionnaires administered online examining insomnia symptoms, nightmares, alcohol use, and suicide risk.

SETTING

University.

PATIENTS OR PARTICIPANTS

375 undergraduate students at a large, public university in the southeastern United States.

INTERVENTIONS

N/A.

MEASUREMENTS AND RESULTS

Results indicated that insomnia symptoms significantly mediated the relation between alcohol use and suicide risk; however, this mediation was moderated by gender. For women, there was both a direct effect of alcohol use on suicide risk as well as an indirect effect of alcohol use through insomnia symptoms increasing suicide risk. For men, there was no direct effect of alcohol use on suicide risk, but there was a significant indirect effect of alcohol use increasing suicide risk through insomnia symptoms. Nightmares were not related to alcohol use, and the association between nightmares and suicide risk was found to be independent of alcohol use.

CONCLUSIONS

Insomnia symptoms are an important factor in explaining the mechanism by which alcohol use increases suicide risk.

A longitudinal analysis of drinking and victimization in college women: is there a reciprocal relationship?

The purpose of the current study was to assess the relationship between drinking and severe physical and sexual victimization in a sample of 989 college women over 5 years. Participants completed a Web-based survey each fall semester, beginning as first-time incoming freshman, and continuing each year for 5 years. The survey was comprehensive in assessing drinking, victimization, and relevant covariates. Women were followed whether they remained at university or not. Prior year same type of severe victimization predicted current year victimization, both severe physical and sexual. However, prior year drinking did not predict current year severe victimization. Prior year severe sexual victimization predicted current year drinking. Our findings of a longitudinal relationship between severe sexual victimization and subsequent increases in drinking suggests that college women may be drinking to cope with negative sequelae that they experience as a result of the victimization. We did not find the same longitudinal relationship between drinking and severe physical or sexual victimization, suggesting that a reciprocal relationship does not exist between drinking and victimization among college women. We did find that severe sexual victimization decreased across college, suggesting that the year prior to and the first year of college may be a critical period for intervening to reduce risk for severe victimization.

Prevalence of hazardous drinking among nursing students

AIMS

To estimate the frequency of alcohol consumption among nursing students and describe their behaviour patterns in relation to excessive consumption.

BACKGROUND

Most alcohol-related problems appear in individuals who indulge in hazardous consumption, with hazardous drinkers constituting a priority in the field of preventive activities. According to previous studies, there is a high proportion of hazardous drinkers among university students.

DESIGN

Descriptive cross-sectional study.

METHODS

Over the course of the 2012-2013 academic year, we assessed 1060 nursing degree students, ascertaining their socio-demographic characteristics, lifestyle and alcohol consumption by means of the Systematic Alcohol Consumption Interview (Interrogatorio Sistematizado de Consumos Alcohólicos/ISCA) and Alcohol Use Disorders Inventory Test (AUDIT).

RESULTS

Hazardous alcohol consumption was observed in 43·4% of students. Moreover, 14·9% of men and 18·7% of women met criteria for hazardous drinkers, without any statistically significant difference between the sexes. The frequency of hazardous drinkers was significantly higher among participants aged under 21 years, those living outside the family nucleus and smokers.

CONCLUSION

A considerable proportion of students show evidence of hazardous alcohol consumption and, while there are no sex-related differences, the proportion of hazardous drinkers tends to be higher among the youngest subjects, smokers and persons living outside the family nucleus. Alcohol-prevention activities should envisage greater protection of university settings, particularly where future health professionals are involved.

The Effect of Types of Postsecondary Education on Drinking: Does Age of Enrollment Matter?

Using longitudinal data from early adolescence through young adulthood, this study examined the association between different types of postsecondary education (PSE), age of enrollment in PSE, and the trajectory of alcohol use for Canadian young adults (N = 521). Trajectories of alcohol use were compared across young adults at 2-year colleges, 4-year universities, transfer programs (started at a 2-year college and transferred to a 4-year university), and terminal high school graduates. While initial findings revealed significant differences in the drinking trajectories of 2-year college students and 4-year university students, all differences were accounted for by variability in the age of enrollment. Overall, there were few differences in heavy drinking across types of institutions, but younger students increased their alcohol use more than older students following enrollment. However, young adults who do not attend PSE may be at greatest risk for heavy drinking over time.

Substance abuse in relation to religiosity and familial support in Iranian college students

BACKGROUND AND OBJECTIVES

Drug abuse and alcohol use in young adults are a major public health problem. The aims of present study were to determine the prevalence of alcohol use and substance abuse and related factors in a sample of Iranian college students.

METHODS

The study took place in Tabriz (northwest of Iran) in April and May, 2011. The randomly selected sample consisted of 1837 college students. Data were collected in a survey. A self-administered questionnaire was used to measure smoking, sexual behavior, alcohol and drug use, religious belief, and parental support.

RESULTS

The prevalence of alcohol use in the past 30 days and ever drug abuse were 7.7% and 8.0%, respectively. After adjusting for other factors, living in dormitory in comparison to parental home (OR=0.61) and having higher score of religious beliefs (OR=0.98) were protective factors for ever use of illicit drugs. Being male (OR=1.89), living in the single house in comparison to parental home (OR=2.64), smoking (OR=2.0), alcohol use (OR=4.71), hookah smoking (OR=2.89), and having unsafe sex (OR=2.40) were risk factors ever use of illicit drugs.

CONCLUSION

Our results show low prevalence of alcohol use and drug abuse in Iranian college students and determined some of its associated factors. The findings of this research can be used for planning and evaluating interventions by considering risk and protective factors.

Differences in sexual behaviors among unmarried sexually active students at 2- and 4-year colleges

Sexual risk behaviors are common among college students, but differences between 2- and 4-year students have not been explicitly tested. Survey data from 9,748 unmarried sexually active Minnesota college students (in 2010 or 2011) were used multilevel logistic regression models to test differences in eight high risk sexual health behaviors and outcomes between students attending 2- vs. 4-year colleges. Odds of sex without a condom, sex without reliable birth control, unplanned pregnancy, and STIs were significantly lower among 4-year students than 2-year students, after adjusting for demographic covariates. Health promotion approaches targeted to the needs of 2- or 4-year students may be needed. For example, messaging and outreach efforts encouraging condom use may be especially beneficial for sexual health programs at 2-year colleges.

Adolescence to young adulthood: when socioeconomic disparities in substance use emerge

We examined trends in cigarette, alcohol, and marijuana use by eventual educational attainment in 1,902 participants from Project EAT, a 10-year longitudinal study following participants from early adolescence through young adulthood. Generally, for cigarettes and marijuana, disparities were evident by early adolescence with prevalence of use highest among those who had no secondary education. With alcohol, use diverged during young adulthood when the college group reported the most weekly alcohol use while those without postsecondary education reported greatest daily use. When disparities in substance use behaviors first emerge and later escalate can guide how to craft and target interventions.

Sexual health resources at Minnesota colleges: associations with students' sexual health behaviors

CONTEXT

Sexual risk behaviors are common among college students, and research examining the environmental context of these behaviors is important for prevention. The presence of college sexual health resources is a potentially important part of that context.

METHODS

In a 2010-2011 survey, 6,318 undergraduates from 28 two- and four-year Minnesota college campuses provided data on their sexual health behaviors. In addition, a specially designed inventory was used to assess the sexual health resources available on each campus. Multilevel regression was used to test the associations of four types of resources with students' condom use, birth control use, STD or HIV testing, and unplanned pregnancy.

RESULTS

In models that controlled for students' personal and demographic characteristics, the higher the level of sexual health resources at a college, the lower the likelihood that students had had intercourse without birth control, intercourse without a condom and involvement in unplanned pregnancy. For example, students attending colleges with the maximum number of general clinic resources had a lower predicted probability of reporting nonuse of reliable birth control at last intercourse than students attending colleges with no resources (7% vs. 14%). After college characteristics were adjusted for, most measures of resources remained significant, although associations were reduced; two measures became significant in unexpected directions.

CONCLUSIONS

Colleges' provision of sexual health resources may be associated with students' sexual health behaviors. Research using quasi-experimental or experimental designs is needed to assess the mechanisms underlying these associations; such work could lead to interventions that might help reduce students' risky behaviors.

Mindfulness and alcohol problems in college students: the mediating effects of stress

OBJECTIVE

To examine the relationship between mindfulness and alcohol problems in college students, as well as the role of stress as a mediator in this relationship.

PARTICIPANTS

Participants were 310 students from a small, private college in the Northeast.

METHODS

Students completed self-report measures, including the Perceived Stress Scale, the Five Facet Mindfulness Questionnaire, and the Rutgers Alcohol Problems Index.

RESULTS

Mindfulness was negatively correlated with alcohol problems and stress, whereas stress positively correlated with alcohol problems. Results implicated stress as fully mediating the relationship between mindfulness and alcohol problems. Alcohol problems were negatively correlated with the Acting With Awareness and Describing Experience facets of mindfulness.

CONCLUSION

Mindfulness-based stress reduction or other mindfulness programs may be useful in decreasing alcohol problems on college campuses via the effects on stress.

Associations between energy drink consumption and alcohol use behaviors among college students

BACKGROUND

To explore associations between energy drink consumption and alcohol use among college students.

METHODS

Participants included 585 students (m age=18.7; 47.0% White, 21% Hispanic, 25% Asian, 7% other race/ethnicity; 56.0% female). Energy drink behaviors included past month and past week consumption. Alcohol use behaviors included past month and past two week consumption, as well as heavy drinking and quantity of alcohol consumed. Consumption of energy drinks mixed with alcohol was also measured. Linear and logistic regression analyses between energy drink consumption and alcohol use were run controlling for gender, age, and race/ethnicity.

RESULTS

For each one unit increase in past month (i.e., additional day used) energy drink use, the likelihood of past month alcohol use increased by 80%, heavy drinking by 80% and past month energy drinks mixed with alcohol use by 90%. Similar results were found for past week energy drink use. A positive relationship between energy drink use and quantity of alcohol consumed during a single episode of drinking was also found (p<0.001). Significant gender interactions between energy drink consumption and alcohol use as well as quantity of alcohol consumed were found, with relationships stronger among males than females. There were no significant interactions by race/ethnicity.

CONCLUSIONS

Energy drinks are readily available to students and pose potential health risks. Students who report greater energy drink consumption also consume more alcohol, are more likely to mix energy drinks and alcohol, and experience heavy episodes of drinking, which is problematic given the potential negative consequences of these drinks.